Preamble

The House met at half-past Two o'clock

PRAYERS

[MADAM SPEAKER in the Chair]

MESSAGE FROM THE QUEEN

QUEEN'S SPEECH (ANSWER TO ADDRESS)

The VICE-CHAMBERLAIN OF THE HOUSEHOLD reported Her Majesty's Answer to the Address, as follows:
I have received with great satisfaction the loyal and dutiful expression of your thanks for the Speech with which I opened the present Session of Parliament.

Oral Answers to Questions — SCOTLAND

The Secretary of State was asked—

Tax-varying Powers

Mr. Graham Brady: If he will make a statement about the technical measures to allow tax-varying powers to be introduced in Scotland. [61263]

The Minister for Home Affairs and Devolution, Scottish Office (Mr. Henry McLeish): The Government are working to ensure that the tax-varying power will be fully in place and available for use by the Scottish Parliament from April 2000. The Inland Revenue has consulted widely and is continuing to work with a group of industry representatives on the measures required for implementation of the Scottish variable rate.

Mr. Brady: I thank the Minister for that reply. It will obviously be an expensive and inefficient process to administer a Scottish tax. The Government claim to be opposing vigorously proposals in Europe to harmonise taxes with the United Kingdom, on the grounds that such harmonisation would be bad for the United Kingdom. Will the Minister confirm that it would also be bad for Scotland if its tax levels were higher than England's?

Mr. McLeish: The Scotland Act 1998 has been premised on the basis that we want to provide a level playing field across the United Kingdom in the regulatory powers affecting industry. Moreover, I remind the hon. Gentleman that, on 11 September 1997, the Scottish people decided that they would like the Scottish Parliament to have power to vary the basic income tax rate. That power was endorsed by the Scottish people, and we are in the process of implementing our commitment

on it. We believe that it is right for the Parliament to have such a power, and it will be up to the Parliament and the parties in it to decide whether to use it.

Mr. John Home Robertson: I do not think that my hon. Friend needs to take any lectures on expensive and ineffective taxation from those who gave the poll tax to Scotland. May I try asking my hon. Friend a hypothetical question? If he were minded to set up a Scottish army, Scottish navy and Scottish air force, and to establish Scottish embassies around the world, does he think that he would be able to do so from revenue of threepence on income tax?

Mr. McLeish: I shall resist the temptation to go down that particular road. However, I think that the House might be interested to know that the Labour party has ruled out use of the tax when we are elected to Holyrood, whereas the Scottish National party is still dithering and confused about whether it might use it. Suffice it to say that, in a recent weekly publication, the SNP suggested that if it did not use the Scottish variable rate, it might want to consider
purging quangos and taking a closer look at … Scotland's enterprise network to find extra resources.
The real challenge is for the nationalists to come clean on the Scottish variable rate.

Mr. James Wallace: Will the Minister of State confirm that the tax-varying powers, if used in full, amount to £450 million? Will he confirm also that further sums should be within the Scottish Parliament's direction, but that, according to media reports today, United Kingdom Departments are trying to find ways of not informing the Scottish Parliament about those funds? Will he say what action the Scottish Department has taken to ensure that the Scottish Parliament will not be short-changed, and that the concordats will be honoured in both spirit and letter?

Mr. McLeish: It has always been the case, and always will be the case, that we will get what we are entitled to. There is no plot to snatch back funds from the Scottish Administration.

Mr. John McAllion: Is not a vote in favour of a tax increase by the Members of the Scottish Parliament currently the most important technical provision allowing a tax increase in Scotland? Does my hon. Friend agree that, although such a vote would grab headlines in Scotland, it might not do the same elsewhere in the United Kingdom? Does not that fact make the case for a separate Scottish "Six O'Clock News" programme broadcast and controlled from Scotland, and underline the boneheadedness of those in the BBC who are trying to prevent such a separate Scottish broadcast?

Mr. McLeish: I am, yet again, being tempted down another road, which I shall again resist. On the important issue of taxation, suffice it to say that the Scottish people endorsed the measure on 11 September, and that we have been working very hard with the Inland Revenue and the business community to ensure that it is a success. Regulations will in the near future be laid before the House, putting the flesh on the bones of the measure.

Dr. Liam Fox: The Minister of State will undoubtedly be aware of Scottish Life's estimates of


the compliance costs—£170 million—of the tartan tax, regardless of whether it is used. Will the Minister tell us what discussions he and other Ministers have had with the Inland Revenue on compliance costs, and on who will pay the required sum? Will it be paid out of the Scottish block or by United Kingdom taxpayers as a whole?

Mr. McLeish: Throughout the process of discussing the Scottish variable rate and other matters in the Scotland Act 1998, we have been in close consultation with the Inland Revenue and with the business community. Of course we have also dealt at length with the assurance industry. We are working with a consultative group of industry representatives on formal compliance cost assessments for future publication, and we are fully aware of the concerns that have been expressed by the life assurance industry. It is one area in which dialogue has met with success.
We are convinced that we shall have the Scottish variable rate power available from April 2000, which is what matters to Scots. I can reassure every hon. Member that it will be done in an efficient way, to ensure a value-for-money approach at all times.

Dr. Fox: That was an answer that we can chew over in Hansard to see whether we are any the wiser. Does the Minister agree that the real danger is that of backdoor taxes, with different groups competing to spend Scottish taxpayers' money? Keith Geddes, the president of the Convention of Scottish Local Authorities, suggested a bed tax on tourists, Lord Steel suggested a caravan tax for visitors and Scottish Natural Heritage has suggested a sightseeing tax around Loch Lomond. Will the Minister give a commitment on behalf of the Labour party to rule out not only the use of the tartan tax, but an increase in the overall burden of tax on the Scottish people via the Scottish Parliament?

Mr. McLeish: Those concerns were brought to the House early in the debate on the Scotland Bill. It is now an Act, published on 19 November, but the Conservatives appear to have learnt little. The power exists to vary the Scottish basic rate of income tax. We think that that coincides with the wishes of the Scottish people and with the wish of the business community not to be inundated with new taxes. That will be the settlement for the Scottish Parliament. We shall have it in place by April 2000.

Mr. Dennis Canavan: Will my hon. Friend remind the Tory party that the people of Scotland voted in the referendum just last year for a Scottish Parliament with the power to vary tax? Does he agree that there is a strong case for the future development of fiscal autonomy for the Scottish Parliament, to give its Members the responsibility for raising the money that they want to spend on important services such as the national health service and education, instead of being dependent on decisions taken by the United Kingdom Government or votes in this House?

Mr. McLeish: My hon. Friend is right to point out that the Scottish people have endorsed the Scottish variable rate—it is important to underline that. It is also important to stress that the use of the variable rate is a power available to the Parliament. Any party can stand on a

manifesto to raise that money and spend it. The Labour party has decided not to stand on such a policy. I challenge the nationalists to come clean and say whether they would use the Scottish variable rate. If not, what other sources of funding would they have?

Economic Development

Mr. Andrew Lansley: When he next intends to meet representatives of Scottish Enterprise to discuss economic development. [61264]

The Secretary of State for Scotland (Mr. Donald Dewar): My colleagues and I regularly meet Scottish Enterprise, which plays an important part in the Government's proposals to modernise the Scottish economy. The most recent meeting was between my noble Friend the Minister for business and industry and the chairman and executives of Scottish Enterprise on 4 December.
Following assurances given to the Select Committee on Scottish Affairs, my strategy guidance to Scottish Enterprise entitled "Renewal and Enterprise" is being published today, and a copy has been placed in the Library.

Mr. Lansley: I am grateful to the Secretary of State for that reply. When he next meets Scottish Enterprise, will he acknowledge that, with unemployment rising in Scotland, 12,000 job losses announced this year and business surveys increasingly showing falling order books in Scotland, he and his colleagues, particularly the Chancellor of the Exchequer, have left Scottish Enterprise ill equipped to respond to the impact of the Government's macro-economic policies?

Mr. Dewar: I shall start at the bottom—that is probably appropriate when dealing with the hon. Gentleman's questions. The budget for Scottish Enterprise is more than £440 million this year. It is adjusted, but remains substantially above £400 million. The reasons are that Hyundai did not come on stream, we are spending £70 million through the new deal on training and we decided, with the agreement of Scottish Enterprise, that it should spend less on property and more on its mainstream activities.
On the Scottish economy, the hon. Gentleman could not be more wrong. Of course none of us knows what the future holds, but he will know that the unemployment claimant count is at its lowest since 1977, that last month's unemployment figures again showed a drop in Scotland and that, looking at not just the bad news headlines but the good news headlines about the creation of jobs, there is a significant balance in Scotland's favour.

Ms Sandra Osborne: May I take this opportunity to express the gratitude of the people of Ayrshire to my right hon. Friend and his colleagues for their response to the ending of Jetstream 41 production at Prestwick, which was to set up the Prestwick task force? As a member of that task force, I am aware that the report to be published shortly will show that substantially more jobs have been created than were originally lost. Does my right hon. Friend agree that such partnership working sets a good example for elsewhere?

Mr. Dewar: Yes. I thank everybody, including my hon. Friend, who served on the Prestwick task force. It has been a success. I am also grateful to the firms that took the opportunity presented by the site at Prestwick. It is now a hub of activity and I am sure that it will grow and prosper in future. My hon. Friend the Member for East Lothian (Mr. Home Robertson) had a similar experience with the closure of Mitsubishi at Haddington, where energetic local action, using local talent, skills and advantages, did much to redress the balance.

Mr. Archy Kirkwood: When the Secretary of State next meets Scottish Enterprise, will he continue to discuss the particular difficulties being faced in south-east Scotland owing to the recent spate of redundancies? Is he aware that there is high expectation in the borders that when the Scottish Office working party reports in the next few days it will provide adequate additional resources to make a significant difference to those difficulties? In particular, will he make sure that any projects to expand employment in existing local businesses arising through the Scottish Enterprise network will not be knocked back by central Government because of a lack of funds?

Mr. Dewar: We have made it very clear that good, viable projects will be encouraged in every way. That applies across Scotland, but we are particularly aware of the difficulties in the south of Scotland and in the hon. Gentleman's constituency. We cannot offer the prospect of immediate success in solving all the problems, but there are a number of encouraging factors.
There is a very good spirit of co-operation in the area and we have every intention of continuing to work closely with local interests. Some of the matters that were raised with me when I was there have been dealt with in another way and in another forum. For example, the recent settlement of some of the immediate anxieties of the farming industry has been widely welcomed in the south of Scotland.

Dr. Norman A. Godman: My right hon. Friend will forgive me for being parochial, but when he next meets representatives of Scottish Enterprise will he urge upon them the need to assist the further development of the waterfront at Port Glasgow—not in my patch—Greenock and Gourock? The Government also need to assist with the proposal by Clyde ports for the development of a passenger ferry terminal at Port Glasgow. It makes excellent sense and would provide lots of jobs on the lower Clyde.

Mr. Dewar: I of course appreciate the importance of the issue that my hon. Friend raises. There has been a great deal of work and a great deal of success has been achieved. There have also been disappointments, such as the unfortunate closure of National Semiconductors, but new jobs have also been created, for example at IBM, on a very extensive scale. Again there is a balance to be struck. I am aware of the particular project to which my hon. Friend referred at the end of his question; it is something that we will watch very carefully.

Mr. Nigel Evans: Is not the truth of the matter that job losses are on the increase in too many parts of Scotland? While the Secretary of State

concentrates on trying to get another job for himself—a prospect that is fading faster after the north-east Euro by-election—others are losing their jobs. With high interest rates compared with the rest of Europe, too strong a pound hitting exports, and high on-costs on wages even before the minimum wage starts pushing unemployment even higher, is the only hope for those losing their jobs due to Government policy to follow the lead of the Paymaster General and advertise their availability for hire in the "Yellow Pages"?

Mr. Dewar: I suppose that the hon. Gentleman is trying to add to his reputation as a statesman. Obviously he was not listening or decided to ignore what I said earlier. If we compare the job losses that have been announced since the beginning of the year and the job promises that have been made—I recognise that promises do not always turn into reality—and even if the promises are only two thirds fulfilled, it is clear that we are in balance.
Unemployment in Scotland has been falling steadily. I shall not attempt to predict the future because there is a world crisis and a contagion of fear in the international market—we cannot be totally immune from that—but we have a stable economy as a result of two years of tough but necessary decision making by my colleagues in the Treasury. We are thus in a good position to ride out the problems, and the figures remain encouraging.

Further Education

Mrs. Maria Fyfe: What plans he has to review the organisation and management of further education, with particular reference to industrial relations issues. [61265]

The Minister for Education, Scottish Office (Mrs. Helen Liddell): The Government have asked the further education sector to play a leading role in the delivery of our key programmes for education, social inclusion and competitiveness and we are increasing expenditure in the sector by £214 million over the next three years. To ensure that that money meets the challenges that the Government have set the sector, I intend to ask the new Scottish Further Education Funding Council to review the management of further education colleges. I will announce a detailed remit for the review shortly.

Mrs. Fyfe: That is excellent news which will be widely welcomed. Will my right hon. Friend say whether, as part of the review, the restoration of the national negotiating machinery will be considered? That machinery was taken apart by the previous Government, despite the fact that they were warned about the likely consequences in places such as Motherwell college. Responsible and experienced trade unionists, who knew what they were talking about, told the then Government what the results would be, but their views were ignored.

Mrs. Liddell: I take my hon. Friend's point about bargaining in further education colleges. There is a mixed message across Scotland about the impact of localised bargaining, but I have no doubt that the review board will consider the matter and come to conclusions on it. As she knows, I have no specific locus in industrial relations


matters, but I recently visited Motherwell college, where I asked both management and the trade unions to resolve their difficulties as quickly as possible. The only people who suffer in such situations are the students, who are all working extremely hard.

Mr. Ian Bruce: Does the right hon. Lady see any problems with the difference between the supposed increases in expenditure on school teachers and the salaries available to people in further education? The Government have clearly tried to accelerate the amount of funding per pupil in schools, but the same is not true of further education.

Mrs. Liddell: I really wish the Opposition Whips would brief Conservative Members better. If the hon. Gentleman had listened more closely, he would have heard me say that £214 million extra was going into further education over the next three years. Further education is at the heart of the Government's plans for lifelong learning, and we are greatly encouraged by the breadth of experience of lecturers in further education colleges and the role that they are playing in meeting the Government's challenges.

Mrs. Irene Adams: I, too, congratulate my right hon. Friend on the review of further education colleges, especially because of the difficulties that we have had in Renfrewshire with Reid Kerr college in my constituency. Will she ask the review board to consider how the new deal is working in further education colleges? I have heard complaints that new dealers have been turned away in favour of more lucrative students.

Mrs. Liddell: That is an interesting question—I know that my hon. Friend is concerned about the matter. We have invited consultants to look at the operation of Reid Kerr college. We have made it plain to the further education sector that it has a responsibility to its conventional students as well as to those students who have come in under the new deal. I hope shortly to publish the strategic framework for further education, which will take into account some of the structural issues that are causing colleges to compete perhaps needlessly.

Mr. Alasdair Morgan: In view of the dissatisfaction with local pay bargaining in further education to which the hon. Member for Glasgow, Maryhill (Mrs. Fyfe) referred, will the right hon. Lady undertake not to introduce similar arrangements in secondary education?

Mrs. Liddell: The millennium review completed its discussions on salary levels in our schools a short time ago. The review is currently negotiating the role of local authorities as employers with the Convention of Scottish Local Authorities. I am hopeful that, at the end of that process, there will be a settlement for Scotland's teachers that rewards all teachers in a way that recognises their talents. At the moment, there are no proposals on the table for the introduction of localised bargaining.

Mr. Malcolm Bruce: Will the Minister accept that the £2 million real-terms cut in funding for the three north-east colleges of further education has placed a real question mark over the Government's commitment to

"education, education, education"? Does she acknowledge that the cut has led to sudden, abrupt changes in timetables, which are deeply damaging to the students and cause great unhappiness to the lecturers, who are not even consulted in advance?

Mrs. Liddell: As the hon. Gentleman is no doubt aware, we inherited a £5 million public expenditure cut in further education colleges. This year alone, we have increased expenditure by £12.4 million. Early in the new year, I will announce the settlements for colleges, including those in the north. The Government have shown our commitment to further education by giving it the place in the education system that it deserves, and by increasing expenditure on further education across Scotland.

Local Government Reform

Mr. Robert Syms: If he will make a statement regarding the reform of local government. [61266]

The Minister for Home Affairs and Devolution, Scottish Office (Mr. Henry McLeish): The Government are working to ensure that we create modernised local government, delivering the services people need. We appointed the Commission on Local Government and the Scottish Parliament under the chairmanship of Neil McIntosh; it will report to the First Minister in due course.

Mr. Syms: Does the Minister think that the McIntosh commission on local authorities has missed an opportunity by not recommending an anti-corruption commission to look into allegations of wrongdoing in the central belt?

Mr. McLeish: The reason why we did not ask the McIntosh commission to look at that matter is that we are looking at it ourselves. Next week, we will issue a new code of conduct for councillors, which will be part of the question of ethical standards in local government. There will be standards committees for councils, and a standards commission for Scotland, to provide a means of dealing with allegations of misconduct external to the council involved. We have acknowledged that there is a difficulty and we have taken steps to remedy it. We will publish our findings next week, and the Scottish Parliament will legislate.

Mrs. Rosemary McKenna: Does my hon. Friend agree that the root cause of the problems in Scottish local government lies directly with the Conservative party and its botched and expensive reorganisation, which removed from local government a vast number of experienced officers? Is not the bottom line the fact that the Scottish Parliament will work with local authorities to provide the high-quality, modernised services that the people of Scotland desperately need?

Mr. McLeish: I could not agree more with my hon. Friend. For 18 years, local government was neglected and abused. In the past 18 months, we have had an opportunity to tackle problems where they have arisen, but we must go ahead in partnership. I have no doubt that the new Parliament will ensure that local authorities retain their autonomy. We will make sure that standards are improved and that services are modernised. Where it is required, we will rebuild public trust and


confidence. That is an important agenda for the new century—an agenda that it would be impossible to achieve under the Conservative party.

Dr. Liam Fox: Self-regulation by the Labour party in Scotland scarcely fills us with confidence. The Labour party cannot be the solution, because it is the problem. Perhaps the Minister can refresh our memories. How many investigations are currently taking place into misdemeanours in Labour-run councils? Strathclyde regional council last week found that it was leaving a deficit of £78 million for its successor councils to pay up. Was that old Labour, new sleaze or new Labour, old sleaze? How would the Minister describe his party's financial incompetence?

Mr. McLeish: It is clear again that the hon. Member for Woodspring (Dr. Fox), the Opposition's principal spokesman, has completely missed the point. No one is talking about self-regulation by the Labour party. We are talking about a new ethical framework which, I repeat, will comprise a code of conduct for councillors, standards committees for councils and an independent standards commission for Scotland to provide the means of dealing with allegations of misconduct. That will be the basis of an announcement, and the basis for parliamentary legislation in Holyrood. Dealing with the House of Lords may be a trifle easy, but dealing with Scottish local government requires the Opposition to be serious—which they have not been in the past 18 months.

Mr. Nigel Griffiths: Does my hon. Friend realise how much the extra £860 million for local government will improve services, and how welcome it is in the schools in my constituency and elsewhere that an extra £1.3 billion is being spent on our education services over the next three years? That is 15 per cent. above inflation, and far more than was ever given by the Conservative Government.

Mr. McLeish: I welcome my hon. Friend's comments, because that is the reality of Scottish local government. My right hon. Friend the Secretary of State is investing heavily in the future of education. That is important to Labour Members, even if it is not important to Conservatives. We want to invest and modernise, and that requires partnership, which is what the new Parliament at Holyrood will provide.

Mental Health Care

Mrs. Margaret Ewing: When he last met representatives of health trusts in Scotland to discuss delivery of mental health care in Scotland. [61267]

The Parliamentary Under-Secretary of State for Scotland (Mr. Sam Galbraith): I meet representatives of health boards and NHS trusts regularly to discuss matters of current interest. Mental health is a top priority for the Government and we have already introduced a range of measures designed to improve services for the mentally ill. It is vital also that the legislative framework be adequate to meet developments in treatment and care, while having due regard to public safety, so we are setting

up a committee to carry out a major review of the Mental Health (Scotland) Act 1984, which the right hon. Bruce Millan, I am pleased to announce, has agreed to lead.

Mrs. Ewing: I welcome the Minister's comments, but does he appreciate the fact that many of us will want time to study the recommendations that may be made in the review of that Act? This important issue affects many people in Scotland. Will there be nurse-led initiatives in both acute and primary care services, which are very important for everyone; and will the review exclude compulsory treatment, which is a matter on which the Scottish Association for Mental Health, for example, has expressed concern about civil liberties? How will the review be undertaken and when will the recommendations be implemented?

Mr. Galbraith: I am grateful for the hon. Lady's welcome for the review, but she must appreciate the fact that there are two separate issues involved: the legislation under which care is carried out, and the care itself. What I have announced today is a review of the legislation. It will be carried out under the chairmanship of the right hon. Bruce Millan, and we will make further announcements about the membership and remit of the review committee. We hope that it will report in 18 months' time.

Mr. Tom Clarke: Does my hon. Friend agree that there are almost exactly the same number of people with learning disabilities in hospitals in Scotland as there are in the whole of England and Wales? Does he further agree that, before such patients are discharged, there should be proper assessments and advocacy, in line with the Disabled Persons (Services, Consultation and Representation) Act 1986, so that we know what will happen to them? Does he, finally, agree that he has inherited a situation in which there are again more mentally ill people in Scottish prisons this Christmas, simply because the courts do not know where else to send them; and that that is incompatible with the caring attitude of the Scottish people?

Mr. Galbraith: I am grateful for my right hon. Friend's comments on a subject on which he is an expert. He is correct about the figures. There is always a balance to be struck between those in the community and those who are looked after in hospitals. We have not got it right yet, but we are moving in the right direction. I can give an absolute assurance that no person with learning difficulties will leave hospital unless going into care of a very high standard that will offer decency and dignity and the opportunity to live as normal a life as possible.

Dr. Julian Lewis: How many mental health hospitals in Scotland still have mixed-sex wards?

Mr. Galbraith: I cannot give the exact figure. The difference between Scotland's mental health services and those in the rest of the country is that we did not rush into closing all our mental health hospitals and forcing all the patients into the community. We have retained a certain number in hospitals because we think that it is right and proper to provide places of refuge


and asylum. We will continue to do that. It is a question of getting the balance right, and we think that we are near to achieving that in Scotland.

Higher Still

Mr. Michael Connarty: If he will make a statement on the progress of the implementation of Higher Still. [61268]

The Minister for Education, Scottish Office (Mrs. Helen Liddell): Work is proceeding to ensure that Higher Still will be introduced from August 1999. The liaison group which I announced at Scottish questions in November has now met twice to consider issues relating to the implementation of Higher Still. I hope that the contribution of and positive approach taken by all members of the group will ensure that there is no need for any further delays with Higher Still.

Mr. Connarty: Is my right hon. Friend aware of the warm commendations that accompanied the applause after her recent speech to the Association of Directors of Education in Scotland? For her handling of the Higher Still debate, she is becoming known as Scottish education's "flexible friend," although I have suggested that her approach is more firm and flexible than just flexible. Does she accept that the Educational Institute of Scotland's survey of readiness reveals that, because of the cascade training method, many classroom teachers still feel unprepared to deal with Higher Still in the classroom? Will she make it plain to local authorities in Scotland that they should use some of the vast resources that she has made available to them to train teachers directly in the classroom in preparation for Higher Still?

Mrs. Liddell: My hon. Friend makes a good point. I know that he does so with some knowledge of the topic. With reference to the cascade methods used to disseminate training, it is difficult to see how cascading could be avoided entirely, given that tens of thousands of teachers and lecturers are involved in the process, but there should be only one cascade from the principal teacher to the classroom teacher.
I recognise the anxieties of teachers about their preparedness. That is why I have made an additional £24 million available, which makes a total of £40 million for the implementation of Higher Still. A number of local authorities have made available additional in-service training days for Higher Still, and the Government are making available resources for two additional in-service training days. My hon. Friend can be confident that teachers will not be forced to implement Higher Still if they feel that they cannot do so competently.

Mrs. Eleanor Laing: Why will the Minister not listen to professional teachers who are trying to tell her that the element of internal assessment in the Higher Still system will inevitably mean that employers and higher education institutions will have doubts about the validity of exam results achieved by children under the Higher Still system?

Mrs. Liddell: The hon. Lady is misinformed. The structure of assessment that will operate in Higher Still is based on existing structures of assessment. She says that

the Government have not listened. When English teachers felt that the level of assessment was one level too far, the Government undertook to amend the system of assessment available for the teaching of English, and we are now issuing new guidelines.
The hon. Lady is far from the mark when she suggests that employers are unhappy with Higher Still. As recently as four weeks ago, the Confederation of British Industry issued a statement calling for the rapid introduction of Higher Still, because Higher Still meets the needs of employers and is a route towards ensuring that Scottish education maintains and builds on its high standards.

Mr. Donald Gorrie: As flexibility seems to be the key to getting agreement between the Scottish Office and the teachers, will the Minister elaborate on the reply that she gave a moment ago about the extent to which individual schools and departments will be able to go ahead or not, depending on how well prepared for Higher Still the teachers feel?

Mrs. Liddell: The liaison group was established to take that matter into account. There have been two meetings of the liaison group so far, and I am grateful for the hard work that has been done by the group. A third meeting of the liaison group is to take place next week, and it will examine the guidelines to local authorities and the parameters within which decisions are to be taken.

Universities (English Applicants)

Mr. Tam Dalyell: What is his current estimate of the number of applications to Scottish universities from English-domiciled students for the years 1999–2000; and what was the number of applications in November 1997 for the academic year 1998–99. [61269]

The Minister for Education, Scottish Office (Mrs. Helen Liddell): Seven per cent. more English students have accepted places at Scottish universities this year than did last year, which gives the lie to the scaremongering that we heard some months ago. I expect the number of English applications to Scottish higher education institutions for next year to be maintained. We want to offer as many students as possible the opportunity to qualify for higher education in Scotland.

Mr. Dalyell: Will 9 per cent. of the population continue to gain 13 per cent. of the university places? Do not universities such as Heriot-Watt, Stirling and Aberdeen depend financially on the continuation of that position?

Mrs. Liddell: My hon. Friend is concerned following his discussions with representatives of those universities about the level of applications this year. However, we shall not have a detailed analysis of those applications until 15 December, when the Universities and Colleges Admissions Service cut-off date applies. I shall try to find out what impact there has been on specific disciplines, and the Government are committed to monitoring the introduction of new student support arrangements, which is why the Quigley committee has been established.

Mr. Jonathan Sayeed: What is the social profile of the students to whom the Minister referred? Will she publish the figures on 15 December so that we can determine whether the new students have rather well-off parents?

Mrs. Liddell: I am afraid that I must disappoint the hon. Gentleman, who is searching for gloom where none exists. Analysis by UCAS of the social classes of United Kingdom applicants suggests that the proportion from poorer backgrounds this year is similar to that last year. The scaremongering was all for nothing.

Mrs. Ray Michie: Can the Minister say how many English students have applied to the university of the highlands and islands, and, in particular, to Argyll college? She will be aware that, although the college's prospectus is out, there is no funding with which to run the college, and that has put it in jeopardy in an area that has no further education facilities. Will she and her Department do something about that immediately?

Mrs. Liddell: I am slightly ahead of the hon. Lady, because I met representatives of Argyll college last week. I recognise the difficulties in Argyll, an area with no ready access to further education. I am anxious that Argyll should benefit from the university of the highlands and islands. I cannot give the hon. Lady statistics disaggregated for applications for higher education in Argyll, but I know of the strong academic record of Argyll—particularly at Dunoon grammar school, which has sent a high proportion of hon. Members to the House—and I look forward to a solid future for Argyll. My officials are giving what assistance they can to Argyll college, because it is important to put together a sustainable business case for the college's proposals on marine education. I am anxious to give the maximum support to ensure that Dunstaffnage puts together a viable case that will provide future stability.

Manufacturing

Mr. Nicholas Winterton: If he will make a statement on developments in the Scottish manufacturing sector. [61272]

The Parliamentary Under-Secretary of State for Scotland (Mr. Calum Macdonald): In the year to the second quarter of 1998, manufacturing output increased by 4.6 per cent., compared with the previous four quarters, and growth was evident in seven of the 11 manufacturing sectors.

Mr. Winterton: Are the Minister and the Labour Government concerned by the Office for National Statistics index of production, which showed manufacturing output in the three months to October falling by 0.7 per cent. and business failures in September rising by nearly 18 per cent? Do those figures result from the tax on savings, the increases in taxation and the increase in business costs that the Government have brought into effect.

Mr. Macdonald: As I would have predicted, the hon. Gentleman is being selective. As I have said, in the year to the second quarter of 1998, manufacturing output

increased by 4.6 per cent. In the past month, there have been excellent announcements by various companies: Fullarton Computer Industries will create 500 new jobs in Prestwick; Universal Scientific Industries is creating 700 jobs at a new plant in Irvine; and Walter Alexander, the Falkirk coach builder, has won a £15 million contract from Hong Kong for 122 buses, which is commendable in a difficult export climate.

Ms Roseanna Cunningham: Will the Minister advise the House whether he thinks that the Scottish manufacturing sector will be adversely affected by an emergent Whitehall culture, which is demonstrated in a recent leaked memo stating that as little information as possible is to be given to the Scottish Parliament even in areas of devolved powers? Does he think that that grudging attitude is appropriate?

Mr. Macdonald: Manufacturing would, of course, be wrecked by the uncertainties caused by any move towards separation and independence. I must emphasise that there is no plot to snatch back funds from the Scottish Administration. Funds that are already with the Scottish Office will automatically transfer to the Scottish Parliament and the White Paper stated that Scotland would continue to benefit from its appropriate share of United Kingdom public expenditure.

Oral Answers to Questions — LORD CHANCELLOR'S DEPARTMENT

The Minister of State was asked—

Commonhold Tenure

Mrs. Jacqui Lait: When he expects to publish his proposals on commonhold property tenure. [61248]

The Minister of State, Lord Chancellor's Department (Mr. Geoffrey Hoon): The Department of the Environment, Transport and the Regions is consulting on proposals for leasehold reform. That consultation deals with issues similar to those that would have to be covered in consultation on a commonhold scheme. Therefore, it would be sensible to consider the results of the DETR exercise before embarking on our own consultation. Meanwhile, work on developing proposals is continuing.

Mrs. Lait: I am grateful to the hon. Gentleman for that reply, but it would help those of us who are interested in leasehold reform if we could consider commonhold in parallel. In the past, he told us that some difficulties have emerged since the 1996 Bill was drafted in the Department. Can he tell us what problems remain on commonhold and whether he would accede to the suggestion that we consider commonhold along with leasehold reform, rather than afterwards?

Mr. Hoon: The reason it was decided not to proceed in parallel was that any proposal for a commonhold scheme would inevitably have to cover many areas on which the DETR is consulting on leasehold. For example, relations between individuals and their landlord—whether he or she is a freeholder or a commonhold association—relations between individuals, managers and agents,


valuation and dispute resolution processes and a number of other areas are common to both matters. It seems to us to make good sense to keep the systems in step in so far as we can to ensure that any benefits that result from leasehold reform are also available to commonholders. However, we are continuing with the preparatory work so that as soon as the consultation period on leasehold reform is completed we will be in a position to proceed with any further proposals on commonhold that may be necessary.

Justice (Local Administration)

Mr. Barry Sheerman: What steps he is taking to improve the local delivery and administration of justice. [61252]

The Minister of State, Lord Chancellor's Department (Mr. Geoffrey Hoon): On the criminal side, our plans for developing the local delivery and administration of the magistrates courts service were announced in statements to both Houses on 29 October 1997. As a result, smaller magistrates courts committees are amalgamating, leading to an increase in administrative efficiency for the areas involved. On the civil side, the Court Service is responsible for ensuring an appropriate balance between the delivery of local justice and obtaining value for taxpayers' money. The Access to Justice Bill, which was introduced on 2 December, will continue our programme of reform.

Mr. Sheerman: My hon. Friend will know that I approve of, and congratulate him on, many of the things that the Department is doing. However, on local justice locally delivered, many of my constituents and many magistrates are concerned that the rationalisation that is still continuing apace in magistrates courts is very similar to that carried out under a previous Administration. The proximity of courts to everyday life and work is important, especially for people from impoverished backgrounds—those people who suffer from social exclusion—so that they can be in their community and get to court easily. Therefore, will my hon. Friend have a word with some of his civil servants? The proposal may look good on the map and may be good for rationalisation and efficiency as regards the taxpayer, but surely local justice should still be locally delivered.

Mr. Hoon: I do not disagree with the principles that my hon. Friend has set out. However, responsibility for local magistrates courts is in the hands of local magistrates courts committees. They decide whether courts should remain open or closed in the first place and it is only when there is an appeal against a decision that the Department becomes involved. Hon. Members who are concerned about the local delivery of justice should use their influence, as I hope that my hon. Friend will, on local magistrates courts committees to ensure that, where appropriate, courts remain open.

Mr. Graham Brady: May I ask the Minister to consider the importance of the county courts as part of the local community as well as part of the delivery of local justice? In particular, will he examine the proposals, which I understand are at an early stage, to

close Altrincham, Tameside and Leigh county courts? That would be a retrograde step in the local delivery of justice and I hope that he will take a close look at it.

Mr. Hoon: I have visited Altrincham county court—in a wholly representative capacity, might I say. I was impressed by the service that it provided to the local community. It is crucial that the local court service can balance the interests of the taxpayer and the cost of county courts against the importance of the local delivery of justice. Most people who visit county courts go there for information; they do not necessarily go there to attend court. There are many ways in which information can be delivered using the benefits of modern technology other than through making available a courthouse facility. I hope that information technology will improve access to information, rather than leaving us dependent on expensive court buildings to deliver the service.

Mr. Elfyn Llwyd: The Minister knows that I have been concerned for some time about the closure of magistrates courts in my constituency. I have seen him at least once on the subject, but he did not assist me much in terms of access to local justice then. It is not only the public—front-line access to justice—who are suffering; justices of the peace in north Wales have told me, fatalistically, that before long their lives will be so miserable that stipendiaries will come in and the whole system of local justice will go.

Mr. Hoon: I simply do not accept that. As I said, the administration of local justice and the magistrates courts is in the hands of local magistrates courts committees. That is the same in north Wales as in other parts of England and Wales. It will remain in their hands because that is the best way to guarantee the local delivery of justice.

Ms Hazel Blears: I am sure that the Minister agrees that, for local people to have confidence in their justice system, it is crucial that magistrates benches be properly representative of the communities that they serve. Unfortunately, that is not the case in Salford. Take three inner-city areas: in Ordsall we have no magistrates; in Langworthy and Seedley we have but one; and in Kersal we have a grand total of five. Such areas suffer the bulk of crime and disorder in our city. Will the Minister reassure me that steps are being taken to increase the number of inner-city representatives on our magistrates benches so that the communities that suffer crime are represented at the heart of the justice system?

Mr. Hoon: I am grateful to my hon. Friend for her question, although she will know that appointments in the Duchy of Lancaster are the responsibility of the Chancellor of the Duchy of Lancaster. Nevertheless, the Lord Chancellor has asked the Central Office of Information to devise a national press campaign to help identify ways of attracting groups who are under-represented on the bench. The Lord Chancellor's Department and the Magistrates Association have worked together to produce a guide for employers explaining the benefits to their companies of having magistrates in the work force. I sincerely hope that the appointments system will benefit from that approach.

Access to Justice Bill

Mr. Dominic Grieve: If he intends to publish a White Paper in advance of the Access to Justice Bill. [61254]

The Minister of State, Lord Chancellor's Department (Mr. Geoffrey Hoon): The Government published their White Paper "Modernising Justice" on 2 December 1998.

Mr. Grieve: I am obliged to the Minister for pointing out that which had already been brought to my attention. May I take him to the reference in paragraph 6.18 of the White Paper on whether salaried defenders will be sanctioned by the Government? He knows that that issue has caused much disquiet in the legal profession and that the White Paper suggests that it will be kept under consideration. Will he explain why clause 13 of the Access to Justice Bill, which was published simultaneously, provides that Parliament will be asked to sanction exactly such a step and will be deprived of the opportunity of legislative scrutiny thereafter?

Mr. Hoon: The explanation is that it is clearly necessary for the Government, subject to parliamentary approval, to have powers to employ salaried lawyers who may one day, if appropriate, constitute a public defender service. The Government have no plans to take forward any comprehensive scheme, but it is right that Parliament should have the opportunity to debate in principle whether that may one day become a feature of our criminal defence service.

Dr. Alan Whitehead: Will my hon. Friend acknowledge the bewilderment that members of the public who have recourse to the law feel when they have dealt with a lawyer whom they trust and believe is competent to carry out their business and that lawyer is suddenly replaced in court by someone whom they have barely met and do not know? Will he emphasise to me the Government's commitment to ensuring that access to audience is seriously pursued?

Mr. Hoon: I am grateful for my hon. Friend's question. He will know that the Bill and the White Paper set out proposals to eliminate the remaining restrictive practices between solicitors and barristers to allow all those who have qualified as either a solicitor or a barrister to appear in all the higher courts. That is a welcome improvement in the rights of ordinary people to secure legal representation and will eliminate the problems that my hon. Friend so well describes.

Mr. Edward Garnier: The Minister will recognise that the Access to Justice Bill will deny citizens the right to select a defence lawyer of their choice. How does that comply with the Human Rights Act 1998?

Mr. Nicholas Winterton: Difficult, Geoffrey.

Mr. Hoon: Not at all.
The provisions that we have set out in the White Paper and the Bill will ensure that those who are represented under legal aid schemes paid for by taxpayers' money have access to specialist representation. We will contract with only those lawyers who are specialists in particular fields. For the moment, anyone who is eligible for legal aid can go to any lawyer, irrespective of whether that lawyer knows anything about the subject in hand. We will ensure through contracting that people still have a choice of lawyer, but they will have a choice of those lawyers who are qualified and experienced in the relevant field of practice. That is a considerable improvement on the present arrangements.

Mr. Gareth Thomas: Does my hon. Friend agree that, whatever the leader of the Bar may say, the majority of those of progressive opinion within the legal profession accept the need to modernise the profession, eliminate unnecessary restrictive practices and improve access to justice?

Mr. Hoon: I was slightly surprised to discover that members of the Bar welcomed our proposals. Although they had one or two "predictable moans", according to a leader in The Times, on balance they felt that our proposals would improve access to justice and would be to the benefit of all those citizens who have to use legal services.

Magistrates Courts (East Anglia)

Mr. Andrew Lansley: What representations he has received concerning the closure of magistrates courts in East Anglia. [61255]

The Minister of State, Lord Chancellor's Department (Mr. Geoffrey Hoon): I have recently received 12 representations from hon. Members, justices of the peace and other local interested parties, following the Cambridgeshire magistrates courts committee's determination to close the March magistrates courts with effect from 31 December 1998. I have previously received representations in relation to the Suffolk magistrates courts committee's decision to close magistrates courts in Suffolk.

Mr. Lansley: I am grateful for that reply. Does the Minister agree that Haverhill in Suffolk is a good instance of a market town—it is in the constituency of my hon. Friend the Member for West Suffolk (Mr. Spring)—that is forecast to grow and should have local infrastructure, but that will see access to justice denied and the abandonment of an important part of the local infrastructure?

Mr. Hoon: I understand the hon. Gentleman's concern about Haverhill and other courthouses in Suffolk, but those decisions were taken by the Suffolk magistrates courts committee. It is curious that the hon. Gentleman should come here and make representations to a


London-based Minister that that Minister should override a local decision which surely was informed by all the factors that he advances on behalf of the case for Haverhill and other such towns.

Mr. Bob Russell: Does the Minister agree that every magistrates courts committee is a quango?

Does he accept that those quangos are taking the decisions that they have taken, not at the behest of local people, but because the Government have starved the service of sufficient resources?

Mr. Hoon: I do not accept for one moment either that magistrates courts committees are quangos or that they are starved of financial resources.

Mental Health Services

The Secretary of State for Health (Mr. Frank Dobson): I should like to make a statement on the Government's proposals to modernise the mental health services as part of our drive to ensure that we enter the new century and new millennium with health and social services that are modern and dependable.
Last year we published our proposals for radical reform of the national health service, and last week we did the same for social services. The strategy document we are publishing today brings together our proposals for far-reaching changes and improvements in the treatment and care which both services provide for people who are mentally ill. We are doing that to emphasise that mental health is not some marginal responsibility of the NHS and local social services—far from it: it must be at the heart of both. That is because mental health is not an obscure minority concern. It is just as important as physical illness and the two can be closely interlinked.
Mental illness is as common as asthma: it affects as many as one in six adults at any one time. It ranges from high levels of anxiety or deep depression to severe and enduring illnesses, such as schizophrenia, which affect one person in a hundred. Mental illness is extremely disturbing to sufferers and their families. It can leave people without insight into the consequences of their actions, which is very frightening; in addition, mental illness is little understood. Those factors combine so that mental illness carries a stigma. In turn, the stigma frightens sufferers and their families, and can lead to people postponing getting the treatment they need.
Partly because of that, mental illness does not get the prompt, effective and sympathetic attention it both deserves and needs. As a result, people who are mentally ill, their carers and the professional staff responsible for their welfare have suffered from ineffective practices, an outdated legal framework and lack of resources. We want to deal with all those aspects to bring about a dramatic change for the better in the treatment and care of all those who are mentally ill. In particular, we want to make sure that proper attention is given to the disturbing growth in the number of young people who are mentally ill, and to the particular needs of certain ethnic groups.
Most people who suffer mental illness are vulnerable people who pose no threat to anyone but themselves. Their condition may make it hard for them to keep a family together or hold down a job, but their behaviour is mild and inoffensive. Most of them are not getting all the low-intensity support they need. That is partly due to the fact that confidence in the whole system is in crisis, mainly because it is not coping with the small minority of mentally ill people who are a nuisance or a danger both to themselves and to others. That is where the policy of care in the community has failed: its failure to deal effectively with the most severe cases has dealt a blow to all mental health efforts and lost the confidence of the public.
Discharging people from hospitals brought benefits for some, but it has left many vulnerable people who find it difficult to cope. Others have become a danger to themselves and a nuisance to others. Too many have been left wandering the streets and sleeping rough, and a small but significant minority have become a danger to the

public as well as to themselves. That cannot go on, so we are putting in place a new strategy to tackle the problems faced by patients, professionals and public alike. We have to take steps to tackle the most extreme manifestations of mental illness, because if we do not, the other people who are mentally ill will not get the attention they deserve and need.
That is why we must bring the law on mental health up to date. That law was formulated at a time when most mentally ill patients were treated in hospitals, so it now reflects the practices of a bygone age and must be modernised to cope with the problems of today. At present, some people who would once have been left locked up in a hospital are fine living in the community; others are only safe providing they take their medication. However, some of those who can become a danger to themselves and others refuse to comply with the treatment they need. That cannot be allowed to go on, which is why I have set up a review of the law on mental health. We need a law that works in a crisis, not one that fails in a crisis.
Similarly, there is a small group of people with an untreatable psychiatric disorder, which makes them dangerous. At present, neither law nor practice are geared to cope with them. They cannot be taken into a mental hospital if they will not respond to treatment, and they cannot be put in prison unless they have committed an offence. If they are sent to prison, they can be a danger upon their release. Therefore, the Home Secretary and I are considering proposals to create a new form of renewable detention for people with a severe personality disorder who are considered to pose a grave risk to the public.
That raises all sorts of ethical and practical problems, but we are convinced that the safety of the public must be the prime concern. People whose mental illness poses a threat to others constitute a very small minority, but we must be able to deal with them. Their illness is often an even bigger threat to them, and our new system should be better both for them and for the public.
Our mental health strategy goes much wider than that, and there are huge developments in both policy and practice. We will put in place a national service framework, which will spell out for every part of the country the range of services that are needed to treat and care for the mentally ill and how best to deliver them. We are being advised about that by an external reference group chaired by Professor Graham Thornicroft from the Maudsley hospital. I thank him and his colleagues for their work in that area.
In the meantime, we are getting on with the improvements that are unarguably needed. There is a pressing need in some parts of the country for more mental health beds and for 24-hour services to be available. We want the services that are provided to be safe, sound and supportive: safe to protect the public and the most vulnerable patients; sound to ensure that patients get the best and most appropriate care and attention; and supportive by working with the patients, users, carers and local communities to help mentally ill people live as independent lives as possible. The strategy works best when patients and carers are involved in shaping services to meet local needs.
Those services, which back up informal carers, will be provided by the national health service, social services and voluntary bodies. All must work together to ensure


that people who are mentally ill get well-organised and unified treatment. Proposals in the forthcoming national health service Bill and Local Government Bill will promote that policy.
This year, the planning guidance issued to the national health service was issued as joint guidance to the health service and social services to emphasise the need for them to work together. The National Institute for Clinical Excellence, which we shall establish, will issue clear and authoritative guidance on the most effective drugs and therapies for use in treating mental as well as physical illnesses.
At the same time that those general improvements are being made to the NHS, we are going ahead with much better support for patients and carers. The measures include: access to NHS Direct 24 hours a day; 24-hour crisis teams to respond in emergencies; more mental health beds of the right sort, in the right place; more hostels and supported housing; home treatment teams; and improved mental health training for GPs and others responsible for providing primary care. Other new developments in the NHS, including health action zones and the obligation on health authorities to prepare and implement health improvement programmes, will contribute to improving mental health treatment and care.
I would like to pay a particular tribute to all those who care for people with a mental illness. A great deal of that caring is done by parents, children, friends and neighbours. It is also done by dedicated professional staff. Their work can be very stressful and is sometimes dangerous. We owe them a great debt. They must deal, day after day, with the consequences of policy failures, shortcomings in the law and a lack of resources.
What needs to be done will clearly cost money. Last week, I announced that we had found an extra £185 million to invest in mental health services provided by council social services. Today, I can announce that that sum will be more than matched by our extra investment in national health service mental health services, which will total £510 million over the next three years. That adds up to about £700 million extra investment in mental health services over the next three years on top of the £3 billion already going in.
All that is investment for change. The Government and the public will expect that extra investment to make a discernible difference and help people across the range of mental health needs. At the end of three years, we expect there to be more 24-hour staffed beds, more secure beds, access to new drugs, assertive outreach teams where they are most needed, more day and respite care, more supported accommodation and improved services for children and adolescents.
All those and many more services will make sure that when people have a mental illness, they and their families can turn to top quality professionals to provide the best possible treatment and care in a system that is safe and sound for patients and the public.

Miss Ann Widdecombe: I am grateful to the right hon. Gentleman for his courtesy in letting me have an advance copy of his statement and for ensuring that on this occasion, it reached me in good

time. I have questions about his proposals which I hope he will be able to answer today, but if he cannot, perhaps he will write to me.
First, will the Secretary of State confirm that the view of the profession is that care in the community has been an overwhelming success and that only a small number of inappropriate discharges have caused justifiable concern among the public?
Will the right hon. Gentleman confirm that a major factor in patients defaulting on medication is the rationing of the latest atypical anti-psychotics? Will he give an assurance that community treatment orders will not be invoked until the patient has been given access to all appropriate medication, even if that medication costs more than that currently being used? Will he ensure that guidance from NICE on the prescribing of medication for patients with mental illness does not assume that all patients should start on the older, less satisfactory medication? If NICE recognises a drug as effective, will he ensure that it is always available on the NHS?
Will the Secretary of State commission a study on the real costs to our health service of providing the latest anti-psychotic medication, compared with providing in-patient treatment? Will he state what consultation he has had with those involved with all aspects of mental health, and what are the results of that consultation?
Will the right hon. Gentleman clarify the position of personality-disordered patients in relation to the Mental Health Act 1983 and state what discussions he has had with the Royal College of Psychiatrists regarding the prospects for treatment of those individuals?
Will the Secretary of State clarify the role of the Under-Secretary of State for Health, the hon. Member for Barrow and Furness (Mr. Hutton), in consulting the mental health charities and what reception he has had from those discussions? Is it true that the hon. Gentleman greatly offended the charity MIND with ill-advised comments about enforced treatment?
Will the right hon. Gentleman confirm that care in the community has been in existence since the closure of Victorian-style asylums in the 1950s? Will he confirm that the policy of community treatment orders has caused concern among psychiatric nurses? What steps is he taking to ensure that their fears are not realised?
Will the right hon. Gentleman confirm that the number of dangerously mentally ill patients, from whom the public need protection, accounts for a small proportion of the total population of mentally ill people?
What estimate has the Secretary of State made of the number of new in-patient beds that will be necessary if community treatment orders are not to prove utterly unworkable? How many of those beds will be provided in mixed-sex wards? What is his policy on mixed-sex wards for the mentally ill?
When will the Mental Health Act 1983 be replaced? [Interruption.] I think that some Labour Members do not understand the workings of the Act. Is it not the case that to implement community treatment orders a new mental health Act will be required? Why, in that case, has the Secretary of State failed to win time for one in the Queen's Speech? If mental health is such a priority for him, why could not time have been found in this year's Queen's Speech for a new mental health Act? Can the


right hon. Gentleman confirm—I hope that he will—that there will be no enforced medication for patients outside NHS premises?

Mr. Dobson: I cannot really thank the right hon. Lady for her welcome for what we are proposing. She asked me to confirm that the psychiatric profession's view is that care in the community was a success. It is my job to say what my views are. The right hon. Lady can find out from the profession what its views are. I think that it failed.
We are seeking the views of the various professionals involved in this matter, but some of the shortcomings in the present arrangements arise from the things that some of the professionals have got wrong in the past and, in my opinion, from their adherence to an over-optimistic view of the likely product of care in the community carried to extremes.
NICE will have the clear job of looking at new treatments and new pharmaceutical products, and advising on whether they are sound and should be widely used in the NHS. If they should, they will be funded.
I am afraid that I cannot read my notes. What was the right hon. Lady's fifth question? I am happy to take a hint.

Madam Speaker: Perhaps the right hon. Gentleman will continue. I am sure that it will come to him eventually.

Mr. Dobson: What we have been saying all along is that we want to consult the people who have been involved in these matters but, in view of the track record of some of them, we will have to look carefully at what they say and not necessarily directly accept their advice. Some of them have been responsible for some of the things that have gone wrong. There is a new arrangement in hand and they will have to become accustomed to it, as will the people at MIND who did not like the Under-Secretary of State for Health, my hon. Friend the Member for Barrow and Furness (Mr. Hutton), giving them an outline of what we intend to do.
I heard someone from MIND on the radio this morning and she apparently shares the right hon. Lady's view that there is really nothing wrong. I have seldom heard such a defence of the status quo as was apparent in the right hon. Lady's questions. She emphasised that the policy of care in the community has been in place for a long time. Indeed it has, and it has had time to show whether it works—it has shown that it has not worked. One cannot claim success for a policy that fails the most difficult cases, and that is certainly what has happened with care in the community.
We believe that the law needs to be changed to enable community treatment orders to be introduced; that is one of the reasons why we need to change the law. As I said in my statement, I recognise—it is fairly clear—that the dangerously mentally ill are a small minority. However, I have also emphasised that, until we sort out the crisis that they have created, proper attention will not be given to the other people who need help with their mental health.
We are not looking for national totals for beds. We are conducting a survey of all beds in the NHS to find out what is needed in each area so that we can identify what sort of beds are required. The fact that there is a surplus of beds in Norwich is of no consequence to those facing a shortage of beds in Bristol.
We want to eliminate mixed-sex wards. I have twice stepped in to prevent health trusts from following the policy of the previous Government and trying to create more mixed-sex wards. I will not tolerate such wards and they will be eliminated.
The right hon. Lady asked about the provision of legislative time in order to do these things. If she can sort out the Tory party's policy on the House of Lords so that we know whether it will obstruct the passage of our measures during this Session, perhaps we could introduce the legislation for which she apparently yearns.

Mr. David Hinchliffe: I warmly welcome many of the points made by my right hon. Friend the Secretary of State. I welcome also the Government's recognition that serious problems are facing a minority within the community.
I find myself in some difficulty because I agreed with the first point made by the right hon. Member for Maidstone and The Weald (Miss Widdecombe) about community care being a success for many thousands of people. There are many thousands, who do not make news headlines, who are better off cared for in the community as a consequence of the community care policy. At the same time, I accept that there have been some very serious failures and tragedies that should be addressed, and my right hon. Friend is right to address them.
I say that in the context of regretting the view of some people that there was a golden age of the lunatic asylum; there was not. I am old enough to remember the Stanley Royd hospital in my constituency and other long-stay psychiatric hospitals, which left a great deal to be desired. I welcome my right hon. Friend's points in that context.
I press my right hon. Friend on two specific points. First—I am particularly concerned about this—does he recognise the urgency of the reform of mental health laws? As he has said, these laws reflect the old asylum system rather than the reality of today's care in the community. We desperately need laws that underpin the work of those who are doing a valiant job in helping people to be cared for in the community.
Secondly—it will not be a surprise to my right hon. Friend—bearing in mind the number of failures that have occurred through a lack of inter-agency working, is it not about time that we addressed seriously the issue of a single community care authority?

Mr. Dobson: First, I shall answer my hon. Friend's final question. He has a great depth of professional and personal knowledge of these matters. I believe that there would still be boundaries wherever we drew the line. I am not in favour of having joint social services and national health service provision. I am sometimes told that such a system works brilliantly in Northern Ireland, while others tell me that it does not.
One of the greatest problems was that the old institutions were awful. In many instances, they were absolutely vile places. It is right that they have been closed down and that people have been moved out. The problem is that some people have been moved out without adequate provision being made for them, either in law or in terms of the services that are available to them. The Victorians may have built great lunatic asylums so that people were out of sight and out of mind; under the previous Government, people were turned out of hospital


and off the books, but we can no longer tolerate that sort of thing. We must ensure that people are properly looked after.
My hon. Friend has made the point that I make whenever I speak on these matters, which is that only a small minority of people are a danger to others. However, there are a huge number who are endangered by not being properly looked after when they are walking the streets. In future, people in both those categories need to be properly looked after, and that is what we intend to do.

Mr. Simon Hughes: First, will the Government accept our welcome for their intention to make mental health a greater priority for the national health service? In particular, we welcome the commitment to assertive outreach, early intervention and 24-hour services, whether they are drop-in services or admission into hospital beds for those who need that provision—and at present, often cannot have it. We join the Secretary of State in his tribute to those who care for the mentally ill, especially psychiatric nurses, community psychiatric nurses and psychiatric social workers, who are often in the front line undertaking extraordinarily difficult jobs.
Will the Government reflect, however, and consider whether it would be better as a policy not to be tough on care in the community, but tough in providing the resources for that care? Is it not the case that many of the problems that have made the front pages of the tabloid newspapers have been caused by overstretched teams not being able to provide such care, rather by people being out in the community and being cared for?
Is the Secretary of State able to tell us the number of beds that he estimates we need to open? More importantly, does not he accept that we are desperately short of psychiatric nurses, community psychiatric nurses and psychiatrists? How many more of these people will be engaged as a result of the resources that he is announcing today?
In the past eight years, there has been a cut of about one sixth in the share of the NHS budget spent on mental health. Will the funds that have been cut be restored? Will the £700 million be £113 million a year for the next three years, or £233 million for the next three years? There are two ways of calculating £700 million, and one total is only half of the other.
Does the Secretary of State accept that—to protect the public and the mentally ill from homicides and, much more often, suicides involving the mentally ill—we need to have better ways of controlling the moment of discharge, often by including a lay element? Does he accept also that—rather than telling people that they will be taken back into hospital if they do not take their drugs, taking away their civil liberties—the test should simply be whether people are well enough to be in the community?

Mr. Dobson: That was a set of weasel words at the end of the hon. Gentleman's questions. It is not simply a matter of people taking their drugs. Day in and day out—

Mr. Hughes: But—

Mr. Dobson: If the hon. Gentleman will listen for a moment, I shall answer his question. Day in and day out,

even in purpose-built, small units trying to provide 24-hour care for those who can go out into the community, if someone has a bad episode—is on the turn—those who are running the place cannot keep that person in if he or she is determined to go out. That is nothing to do with medication but is a practical problem. We have to change the law to deal with that practical problem, and that is what we shall do. We are increasing the amount of money available and the proportion of NHS and social services money spent on the mentally ill. We think that it is right to do that.
I am sorry that I did not follow the hon. Gentleman's arithmetical gymnastics, in which he seemed to disappear halfway up the sum that he originally mentioned.
There are more specialist psychiatric nurses in training, and we want to ensure that there are sufficient nurses and other staff available to do the job that needs to be done. It is certainly true that, across the United Kingdom, there are overstretched teams. To help them, we plan to change the law, to provide extra resources and to change the way in which they go about things. We believe that those three actions combined will lead to a very substantial improvement in the service for all those who are mentally ill.

Mr. John Gunnell: Will my right hon. Friend ensure that, when it is recommended that a patient has electro-convulsive therapy, it will be certain that the hospital providing the therapy has up-to-date equipment and a technician or doctor trained in the use of that equipment, and that, if the patient has any uncertainty about accepting the treatment, the opinion of an independent second appointed doctor will be available before the treatment is provided?

Mr. Dobson: Anyone who is being treated in the national health service should be entitled to treatment using equipment that is sufficiently up to date to be safe and to do the job that it is intended to do, whether it is to treat patients for something that is physically or mentally wrong with them. It is certainly intended that all treatments should be administered by properly trained staff. There is royal college guidance on the matter, and it should be followed. If my hon. Friend feels that we have to follow up and augment the guidance with arrangements in the national health service, I should be happy to contemplate doing so. One of the reasons why we are giving responsibility for quality to the national health service is that we feel that current arrangements are not satisfactory.

Mr. Nicholas Winterton: I served on the Social Services Committee when it undertook a lengthy inquiry into adult mental illness and mental handicap. I warmly support the Secretary of State's statement. The recognition of the failings of care in the community for the more severely mentally ill is long overdue. In-patient hospital beds are required for that small minority. My constituency has experienced two or three tragic deaths as a result of the failure of the system. The Secretary of State made a statement some time ago that no further hospital beds would be closed in the mental health sector. Will he repeat that assurance and promise


that resources will be available to provide the necessary facilities for those with severe mental illness, particularly the more extreme cases of schizophrenia?

Mr. Dobson: I thank the hon. Gentleman for his kind welcome for what I have said and for all the work that he did on the Select Committee, which he chaired with great distinction. On these issues, he sometimes appears to be more supportive of the present Government than he was of the previous one. I do not want to ruin his reputation with his colleagues. He developed a reputation for saying what he believed to be true, which is a good reputation to have anywhere, particularly in the House of Commons. I share his view that unless those who are in favour of care in the community are willing to recognise its failings, we shall not be able to address those failings and get on with the rest of the task.
We do not want any loss of psychiatric beds that does not make sense. We have slowed the process of closure and have instituted an independent review, which is new. There may still be some cases in which moving people out of some of the remaining large hospitals is an appropriate response, but, as the hon. Gentleman says, if that is going to happen, the people must be moved to somewhere that is suited to their needs. I remember drawing the analogy when I was a shadow health spokesman a dozen or more years ago of looking at the old institutions as broken down motor coaches. What is needed is something approaching a custom-built vehicle for everyone who moves out. Sadly, a lot of them have been left to walk.

Audrey Wise: I particularly welcome my right hon. Friend's reference to child and adolescent mental health services. I recommend that he ensures that his Department continues to keep an eye on that theme. When the Health Committee investigated the issue, it was concerned that neglect in childhood was worsening the situation for adult mental health. We were distressed to find that many of those engaged in child and adolescent mental health services felt that their service was a Cinderella of a Cinderella. I urge my right hon. Friend to keep his eye firmly on the issue for economic reasons as well as to ensure a good service.

Mr. Dobson: I thank my hon. Friend for what she has said and for her contribution to thinking on the issue. The strategy document refers to the views of the Select Committee on that. The services for children and adolescents are a neglected part of an already neglected service. We want to put that right.

Mr. Peter Brooke: I thank the Secretary of State for his statement. Will he accept it from me that I have heard the president of the Royal College of Psychiatry say within the Palace that although the present policy constitutes major problems for those on the streets of the Secretary of State's constituency and mine, it has worked a good deal better in rural and suburban areas? Does the Secretary of State further agree that it is important that we achieve, if possible, as much of a bipartisan policy as

we can on so serious an issue, and that we all have a responsibility to build on the common ground of analysis and fact?

Mr. Dobson: I accept most of what the right hon. Gentleman, who represents the neighbouring constituency to mine, says, but nobody could accuse me of bringing politics into this afternoon's statement.

Dr. Lynne Jones: I commend my right hon. Friend on the sensitivity of his statement. One of my earliest recollections is visiting my father in what was known locally as the loony bin, and having my clothes prodded by elderly ladies who were dressed in clothes from the communal store and who looked like children. God forbid that we should ever return to those days of dehumanising institutionalisation. However, the principle of care in the community is not a failure; it is the inadequacy of its resourcing. Will my right hon. Friend assure the House that there will be sufficient well-trained staff with manageable case loads to provide care and support for the majority of mentally ill people who are not a threat to the community, and who for too long have suffered in silence either alone or, if they are lucky, with their families who are equally in despair? Will he ensure that sufferers and their carers are involved in the development of new services? Perhaps he could also consider establishing a mental health ombudsman to look at complaints across the boundaries of social services and health services which so often failed in the past?

Mr. Dobson: In relation to my hon. Friend's last point, the national health service ombudsman can deal with NHS issues and the local government ombudsman can deal with social services issues. There is nothing in law to prevent them from mounting a joint exercise in respect of issues at the boundary. I share her desire not to go back to the old institutions. The provision of care in the community certainly has been under-resourced, but it is not just a matter of under-resourcing. There was over-optimism among some of those concerned about the capacity of patients to cope outside institutions and a failure to provide the necessary back-up. The law is undoubtedly out of date and some of the practices have not been very sound. We are trying to address all three aspects. As I said in my statement, we want to work in collaboration with patients and carers in each locality because all the evidence is that when that is done effectively, it results in a better service for everyone and that is what we are after.

Mr. Dafydd Wigley: The Secretary of State will be aware that people suffering from learning difficulties—or mental handicap, as it was once known—sometimes need to take drugs in the community. Can he confirm that his statement does not apply in any way to those with learning difficulties, and that each case will be considered on its merits? Does his statement apply only to England or to Wales and Scotland as well?

Mr. Dobson: The statement applies to England alone. We are talking not about the treatment of people with learning difficulties, but about mental health.

Mr. Martin Linton: Does my right hon. Friend accept that the provision of more mental health


beds will be a great step towards ensuring that people who should be in hospital are not kept in hostels? That would be some reassurance for the colleagues and relatives of Jennifer Morrison, who was killed in a hostel in my constituency only two or three weeks ago, and, indeed, for the neighbours of the hostel. Although care in the community was a bipartisan policy, we cannot be totally uncritical of the previous Government, who, between the mid-1980s and mid-1990s, oversaw the closure of 50,000 to 60,000 beds in psychiatric hospitals without making care in the community a reality by ensuring that resources and the provision of hostels kept pace.

Mr. Dobson: I share my hon. Friend's proper concern for the relatives and friends of Jennifer Morrison, who—as we should always remember—died doing the job that we had asked her to do, in difficult and, as it turned out, fatal circumstances. The necessity is to provide services that are suited to the needs of each individual. A place in a hostel may be appropriate for some, whereas a place at home—provided that there is back-up—may be appropriate for others. In some cases, people should be held in secure accommodation. We must recognise the fact—some practitioners, I believe, do not like to recognise it—that people can move backwards and forwards across that spectrum; we are trying to ensure that we can respond sensitively and quickly to those changes.

Mr. David Faber: The right hon. Gentleman's statement and some of his subsequent replies will have a somewhat hollow ring for my constituents in Warminster, where we learned with dismay this weekend that the mental health unit in the local hospital would close. The hospital is not large, if I may use his word; it is a small community hospital that serves a rural area, and its future will be threatened by the closure of the unit. Is he aware that his refusals to meet local health workers to discuss the closure or to answer my questions on it in the House have been viewed at best as discourteous by those who work in the hospital and by those whose family members are being treated there? Given the nature of his statement, will he or one of his Ministers undertake to meet those health workers and local people as soon as possible?

Mr. Dobson: I am not aware of the current state of any closure proposals for the unit to which he refers. I may have to take a decision on it, but I do not know off hand whether that is the case. If I do have to take a decision, I am, as ever, willing to meet the elected Members for the area or to get one of my colleagues to do so.

Mrs. Alice Mahon: I warmly welcome the measures that my right hon. Friend has outlined. I have never understood the argument that it is better to sleep rough or languish in prison than to be given proper short-term asylum and appropriate treatment—if one of my loved ones was involved, I know which option I would prefer. Will he consider the tragedy of the high number of suicides among teenagers? Does he envisage special measures to deal with that vulnerable group?

Mr. Dobson: I thank my hon. Friend, too, for all her efforts on this issue over the years, in and around Halifax,

in the House and in other places. The increase in the number of young people who commit suicide is one of the most disturbing aspects of our society. No one has a ready explanation for that increase or for the general increase in mental illness among children and young people, but we hope that the specific measures that we are taking—not only through mental health services, but through the education service—will help to tackle the problem. We also hope that the changes that we are proposing as a result of the Utting inquiry into children in care will help, especially as a much higher proportion of children in care are mentally ill and a higher proportion of them subsequently commit suicide. Until we have a better explanation for the problem, however, it is hard to do anything about it.

Rev. Martin Smyth: I welcome the statement. Along with my hon. Friend the Member for Macclesfield (Mr. Winterton), I served on the Social Services Committee, and we tabled an amendment—which was not accepted—pressing for secure units and places of asylum. Having said that, I must confess that the general plan of community care has worked tremendously well and, in parts of Northern Ireland, it has been going on for 40 years to good effect.
May I press the Secretary of State on the number of occupational therapists who are being recruited? There is still a great need for such people to help folk with mental illness. Is there a process of reaching out to the Department of Social Security? Recently, I had a constituency case where benefit for a schizophrenic person was reduced from including the major care component to a lower care component. As a result, her husband was not able to look after her and she was readmitted to hospital. Surely there should be greater cross-referencing between the different branches of the caring professions.

Mr. Dobson: The hon. Gentleman's last point is valid, and we are looking at how we can provide a better package of care that includes money and direct help. We are trying to formulate that package, but it is rather difficult. If he has any further ideas, I will be happy to consider them.
Many therapists—not just occupational therapists—can make a contribution to helping people cope with living in the community, and we must try to make the system work as best we can. There was a time—it is still the case in certain circumstances now—when asylum was regarded as a good concept, and as a place of safety and security. However, the asylums became so disreputable that the concept suffered, and the bad reputation and stigma that attached to the word "asylum" have, to some extent, dominated much of the subsequent discourse on the matter. They have made some people reluctant to look at the idea of providing the secure care that is needed by some people.

Mr. Neil Gerrard: I welcome my right hon. Friend's statement, including what he said about the way in which the current system has failed a small number of desperately ill people. In my constituency, a young man, when seriously ill, murdered someone else. The most tragic part of the case was that his family had been trying desperately to get help for him and to get him into secure accommodation. They were not able to do so.
Does my right hon. Friend accept that if we bring in a new and renewable form of detention order, there may be some clear-cut cases but, with any such order, there will be difficult, borderline cases where decisions have to be made as to whether an order is brought in or not? What safeguards does he envisage for the bringing in of such orders? What protection will be provided to someone who might be subject to such an order?

Mr. Dobson: My hon. Friend rightly refers to the small number of what might be described as spectacular and awful failures, but the failure of the system went further than just the people who became a danger. There are many vulnerable people who are walking the streets and who are not getting the attention that they deserve. We should not forget them.
A renewable detention order raises deep and difficult ethical issues. I expect—although I cannot say, because we have asked some distinguished people to look at mental health law—that some form of protection for the individual will be recommended, relating both to people's clinical state and to their freedom as individuals. Both concepts will have to be brought to bear when decisions are made.

Dr. Evan Harris: I welcome much of what the Secretary of State has to say, but will he accept a sixth invitation to agree with the statement that he was wrong to describe community care as failing outright? That gives major concern to people who work in the area. May I invite him to agree that community care may have failed in a few areas for a few patients, but that generally when it has failed, it is because it has never been tried, as it has always been inadequately funded?
Does the Secretary of State accept that in Oxfordshire, with a mental health trust that is effectively in receivership, and with experience of the failures in the tragic Raus and Darren Carr cases, we would be concerned to learn that the extra money allocated to

mental health will not compensate for the real-terms cut in funding that Oxfordshire social services received in the standard spending assessment announced last week?
Does the Secretary of State finally accept that rationing—the "R" word that dare not speak its name from the Government Front Bench—has applied in mental health, the Cinderella specialty, not only in the use or lack of use of new anti-psychotics, but in the provision of beds for the mentally ill near where their families live, and not miles away? Many of my constituents have had to go to Wales to visit their loved ones. Does he accept that rationing exists and that his funding could at least reduce the amount of rationing that occurs in this specialty?

Mr. Dobson: One or two people seem to think that a system that has led to an unacceptable number of homicides and suicides has been a success, but I am afraid that that is not my interpretation. I think that the system of care in the community failed as a totality, because it failed in the most difficult circumstances. One cannot claim success for an arrangement that fails in a crisis. I fully accept that it delivered for a substantial number of people—

Miss Widdecombe: Ah.

Mr. Dobson: The right hon. Lady reacts as though I had never said that before, but I said it in the statement. No doubt she was preparing at the time to jump up and announce that the system had been a success. The people who have committed suicide or killed others are not the only failures. All over the country there are vulnerable people who have not been properly looked after, and that cannot be regarded as a success.
We have just announced that we are putting an extra £700 million into mental health care, on top of the £3 billion already being spent. That is a big step forward, and it is disproportionately greater than the increase in spending on other aspects of health care. We are moving in the right direction. We may not be moving as fast as the hon. Member for Oxford, West and Abingdon (Dr. Harris) would like, but then again, we have to find the money, and he does not.

Tabling Questions

Mr. James Gray: On a point of order, Madam Speaker. You will be aware that, since the amalgamation of the Department of the Environment and the Department of Transport after the general election, it has been the custom for Back Benchers to table oral questions on the environment and on transport separately. Were you aware that, as of today, that practice has been stopped and Back Benchers now have to choose between the environment and transport? Was that decision yours, or was it the Government's; if the latter, would you agree that it is another example of the Government's reluctance to face up to proper scrutiny from Back Benchers?

Madam Speaker: I am grateful to the hon. Gentleman for giving me an indication of his point of order in advance. He is of course right to say that questions will no longer be divided between environment and the regions on the one hand and transport on the other. As a result, hon. Members may submit only one oral question instead of two, as was the practice earlier. The question rota is issued on the instructions of the Government. In the normal course of events, changes are discussed through the usual channels. If the hon. Gentleman wants to pursue the issue, may I suggest that he pursues it through the usual channels?

Mr. Gray: Further to that point of order, Madam Speaker. I have checked with the usual channels, and it has not been discussed in that way so far.

Madam Speaker: That is not my business. The usual channels are the usual channels. My business is the Speaker's business.

Mr. Simon Hughes: Further to that point of order, Madam Speaker. The news of the change has only just filtered through. The information process does not seem to have worked. Will you inquire why hon. Members were not notified of the change? Until today, there were two opportunities for tabling questions to be answered in a fortnight. No notice or circular has been issued. Hon. Members have gone into the Table Office expecting to be able to table two questions—

Madam Speaker: Order. There has been no indication to hon. Members about the change, but of course it is clear on the Order of Questions, which is available to all hon. Members. All one needs to do is to look at the Order of Questions, and there it is.

Orders of the Day — Road Traffic (NHS Charges) Bill

Order for Second Reading read.

Madam Speaker: I have selected the amendment in the name of the Leader of the Opposition.

The Secretary of State for Health (Mr. Frank Dobson): I beg to move, That the Bill be now read a Second time.
The Bill does not introduce any new charges. It simply makes it easier for hospitals to collect from insurance companies charges that they have been entitled to collect for nearly 70 years. The present arrangements simply do not work, so the health service is losing a great deal of money. Nobody really knows how much. Estimates range from about £50 million a year to £500 million. Whatever the figure is, it is clear that, if the charges were collected properly, national health service hospitals would be a lot better off.
Under the present law, there are two charges. One is an emergency treatment fee of £21.30, which is supposed to be collected directly from any driver who needs immediate treatment from a doctor after a road accident. The other charge is supposed to be levied on insurers when a motor accident victim makes a successful claim for compensation. At present, this charge can be up to £295 for out-patient treatment and up to £2,949 for in-patient treatment.
Those charges do not work. They combine minimal income with maximum inconvenience. Last year, they raised just £16 million. To collect the emergency treatment fee, NHS staff must ask injured motorists for the money in the immediate aftermath of an accident. That causes maximum offence to the motorists, who may be in shock or pain. They sometimes get the impression that it is a charge for the use of an NHS ambulance. It is not.
Asking for the money is a rotten task for the staff who are supposed to do it. It is a diversion from their real job of looking after patients. In many cases, the emergency treatment fee is literally more trouble than it is worth.
Such problems are not confined to the emergency treatment fee. Motorists and other victims may be pressed while in accident and emergency, or even in a hospital bed, to say whether they are going to make a claim against somebody who caused the accident. Alternatively, they may be sent a letter out of the blue to ask them the same question.
The problems of collecting the charges do not end there. Hospitals sometimes send out letters to motorists to demand payment of one or both charges. That is because it is up to each hospital to track down the organisation responsible for paying the compensation. Each hospital must calculate the costs of the individual treatment provided to each motor accident victim, separating in-patient treatment costs from out-patient treatment costs. Each hospital then has to track the progress of each compensation claim.
The average motor accident injury claim takes two years to process, and many take much longer. The hospital must bill the insurer, and then chase them up and make sure that the debt has been paid. The motorist can get dragged into the process at various stages.
Faced with such protracted and laborious arrangements, most hospitals do not get much income from the charges. Some employ collection agencies, but they have to pay them for their service, which reduces the takings for the hospitals.
We have decided to end that shambles, and to help to make sure both that hospitals can collect the money to which they are entitled and that charges reflect the true cost of the treatment involved. For a start, we have decided to abolish the right of NHS hospitals to levy the emergency treatment fee. General practitioners who attend road accident victims will still be able to levy the fee if they choose to do so.
Having decided that the main charge should be collected properly in future, we considered very carefully how best to go about it. We consulted widely not just within the NHS but with the Association of British Insurers and some individual insurers. We also kept the Law Commission and the Law Society informed of developments. I am most grateful to them all for their advice and help. All concerned with the present scheme wanted a simpler, clearer, quicker and less costly system, and that is what we intend to deliver.

Mr. Simon Hughes: During the debate on the Queen's Speech, the Secretary of State said that it had been estimated that the charge might raise anything between £30 million and £500 million. Can he be more specific today, and if not, why not? Given that he previously led the House to believe that the Government did not favour the introduction of any new charges—presumably he will say that these charges are old charges that are merely being collected—can he confirm that the Government are happy about, and supportive of, all the other charges currently placed on people who use the NHS?

Mr. Dobson: The Bill is about one charge that hospitals have lawfully collected since 1930, and another that has been lawfully collected by hospitals since 1933. I understand that both were introduced with the support of the Liberal party. All we are doing is getting rid of one of them, and making the other one work. There is nothing new about either of them.
We propose that the compensation recovery unit of the Benefits Agency should take on the job of getting the money in and distributing it to hospitals. The compensation recovery unit was set up in 1990 by the previous Government to recover state benefits where both benefits and compensation had been paid out in respect of the same accident, injury or illness. Insurers are required to notify the recovery unit of claims for compensation, so the unit is well placed to take on the additional task of collecting NHS charges.
There are many advantages to our proposal: the recovery unit has a good track record; the unit has good relations with the insurance industry and proven procedures; insurers will need to deal with only one central unit instead of several hundred individual hospitals; the work will be done at minimum administrative cost to all concerned; hospitals will be relieved of an onerous task; the process will require minimal involvement of motorists; and the proposal will secure around 50 jobs on Tyneside, where the recovery unit is situated. The insurance industry supports the proposal.
In a further effort to simplify and reduce administrative costs, we propose to introduce a tariff of charges so that every hospital, every insurer and the recovery unit will know how much the charge is likely to be in every case. In most cases, the only patient information that will need to be transmitted is whether motorists were treated in an NHS hospital as out-patients, and how many days they spent in hospital if they were treated as in-patients. The insurance industry supports that proposal, too.
The charges will be set out in regulations, and will be made up of two items. The first will be a flat rate fee for those who do not need to stay in hospital. Initially, the flat rate fee will be set at £354, no matter how many out-patient attendances are involved. The second item will be a daily rate charge for those who need to stay in hospital, and that will be set at £435 per day initially.
The new tariff has been calculated to reflect the current cost of treating road accident victims. It is expected to bring in a total amount that broadly reflects the costs of treating those who make a successful claim against another driver. As part of the arrangement, I have concluded that it would not be in the spirit of the proposed new system to impose open-ended liabilities on insurers, so there will be a ceiling of £10,000 on a single charge. Both the tariff and the ceiling will be set by regulations, and uprated as necessary.
Following our consultations with the motor insurance industry, we propose that the new charges should apply to treatment given in respect of accidents that happened on or after 2 July 1997, when the Chancellor first announced our intention to collect the full cost of treatment. Treatment for accidents that happened before that date will be charged at the new tariff, but subject to a ceiling of £3,000.

Mr. Robert Syms: Does the £10,000 limit relate to an individual or to an accident? For example, in the case of a coach, 30 or 40 individuals might be involved. Would the liability be multiplied by the number of people in the coach?

Mr. Dobson: It would be per person, as would all compensation claims of that sort. There is nothing different about the claim in question.
As the House knows, the Motor Insurers Bureau, financed by the insurance industry, pays compensation to victims of road accidents caused by drivers who are either uninsured or have disappeared. Under the Bill, the NHS will be able for the first time to collect charges from the Motor Insurers Bureau. By regulations, we will make it clear that payments will be sought from the bureau only in respect of accidents that happen after the Bill is enacted.
The new charging process will be straightforward. It involves adding just one question to the existing standard form, which insurers are already required to send to the recovery unit. It will report which NHS hospital, if any, treated a motor accident claimant. The recovery unit will then get from the hospital concerned confirmation that the claimant was an out-patient, and, if an in-patient, how many days he or she spent in the hospital.
The unit will then be able to collect the charge from the insurer as soon as the overall claim is settled, and pass it on to the hospital. Unless there is some dispute,


each motorist's involvement should amount to nothing more than telling his or her insurer if he or she received treatment in an NHS hospital.

Mr. Michael Jack: Will the Secretary of State clarify one point? If, as a result of a subsequent court case, a motorist were found to be entirely innocent of any blame in an accident that led him or her to receive hospital treatment, would the other party, who was blameworthy, have to accept the entire bill for all the parties involved in the treatment?

Mr. Dobson: The whole question rests on there being a successful compensation claim in the first place. If there is such a claim, it will include the NHS costs. If there is not—possibly, in the circumstances to which the right hon. Gentleman referred—the NHS would not get any money.
We also propose to give insurance companies, for the first time, the right to ask for a review of charges in a particular case, and, where appropriate, to appeal to a tribunal.
There have been a number of scare stories about what we propose. Some people have claimed that we are introducing new charges. Others have claimed that what we are doing will lead to large increases in motor insurance premiums. Neither is true. Nothing is new in principle about what we propose. Insurers have been liable for such charges since 1930. We are merely ensuring that, in future, NHS hospitals will get the money to which they have been entitled for the past 68 years.
The present collection arrangements are such a shambles that no really firm data exist on which to base estimates of the likely sums that may be raised under the new scheme. The best estimates that I can come up with range from around £100 million to about £150 million in England—about £120-odd million to £165 million in Great Britain. The ABI estimates that, if the total impact of what we propose were to be passed on to motorists, premiums might rise by 2 to 3 per cent., or around £6 to £9 per policy holder. That is the ABI's estimate, not mine.
To put this in perspective, again according to the ABI, motor insurance premiums have risen by an average of 16 per cent. for comprehensive policies and 12 per cent. for non-comprehensive policies since 1996. The proposals will have no impact on the no claims bonus of the drivers making the claim for compensation.
In any case, there is good reason to believe that not all the costs will be passed on to motorists' premiums. It was in July last year that we first announced our intention to collect the actual cost of treatment, and we hope to introduce the new scheme from April next year. That means that, by the time the new scheme comes into operation, insurers will have had nearly two years to adjust. That was borne out the other day, when Direct Line was quoted as saying:
rises would be minimal as most insurers have already factored in potential NHS claims".
The Association of British Insurers was quoted as saying:
most companies already take their liability under the existing law into account when assessing premiums.
The principal concern of the insurers has been the fear of retrospective action to recover the sums not collected over the years. In a meeting with me, the ABI said that it

would be prepared to accept 2 July 1997 as the operative date for the changes. It welcomes the simplified arrangements and the tariff system that we propose, so our proposals will not place a large burden on motorists or motor insurers.
The new scheme will bring order out of chaos. It is a sensible, practical measure that will raise much needed extra funds for hospitals in every part of the country. It is sound in principle, and it will work in practice; that is why I commend it to the House.

Miss Ann Widdecombe: I beg to move, To leave out from 'That' to the end of the Question, and to add instead thereof:
`this House declines to give a Second Reading to the Road Traffic (NHS Charges) Bill because the Bill further adds to the burdens the Government has imposed on both commercial and private motorists in that insurance premiums will rise; notes that the proposal did not appear anywhere in the Labour Party's election manifesto, and conflicts with the Government's express opposition to extending charges in the NHS; further notes that these charges will apply only to motorists and not to victims of other insurable accidents; and calls on the Government to clarify its future intentions with regard to both the level and range of any future additional charges in the NHS, and to take into account the impact on the motorist when determining the amounts to be charged.'
It may reassure the Secretary of State to know that the Opposition have some sympathy with some of the aims in his Bill, but we will press our amendment, because certain aspects concern us, and I would welcome clarification of them when the Minister replies.
All Government measures must be considered in the context of overall policy. At the moment, it seems that the Government are determined to penalise motorists. I might have been sympathetic to a proposal to make more effort to collect charges from insurance companies, but I am bound to observe that the Bill will have a disproportionate effect on one group of people who use the NHS.
The Government have already raised fuel duty by 20 per cent., and vehicle excise duty by 3.4 per cent. They have taken powers for an entirely new registration tax on new vehicles. By the end of this Parliament, they will have charged motorists more than £9 billion in extra taxation. If we were to use the Secretary of State's quaint method of counting, that would probably come to £18 billion over three years. If so, one would be tempted to observe that motorists were being asked to fund all the increases that he has promised for the NHS. Perhaps he will not on this occasion insist on his favoured method of counting increases.
It has been estimated—the Secretary of State more or less confirmed it when he mentioned a figure of up to £9—that the proposals will add another £10 or so to motor car insurance premiums; I am happy to come down to £9. On its own, that might not have been too serious, whether the figure was £6, £7, £8, £9 or £10, but, in combination with all the other costs that the Government have inflicted on the motorist, it is of more significance than it otherwise would have been.
Can the Secretary of State explain the position of uninsured drivers? As I read his proposals—I am happy to be corrected—the NHS will not write off the cost if the driver is uninsured, and will not charge the driver directly. Rather, law-abiding motorists will effectively be


charged twice, in that their insurance premiums will have to reflect the costs of uninsured drivers' treatment, even though they have already paid taxes to cover such treatment. What guarantees are there that the income from this charge will not end up as a substitute for Treasury funding? What assurances, if any, will the Government give that they will not increase insurance premium tax?
Where does this stop? What about victims of other insurable accidents? Will the Secretary of State extend such charges to them, or will he give an absolute guarantee that that is not the Government's intention?
What about cases of self-inflicted injury? If the Secretary of State proposes to extend his charges to that group, does he agree that he is introducing a new principle into the NHS of a double whammy on anyone prudent enough to take out insurance? if he does not intend to extend such charges, why pick on the motorist rather than those whose actions are entirely self-inflicted and cost the NHS a great deal in care and treatment? What about those who practise dangerous sports? Where does it stop? Does it stop at all?

Mr. Eric Martlew: Perhaps the right hon. Lady will explain to the House why she voted for the legislation in 1988.

Miss Widdecombe: We did not add the measure to the cumulative effect of a series of taxes that penalise one group of people who may use the NHS. That is exactly what the Government are doing. If the hon. Gentleman had listened—he usually does—he would have found that, right at the beginning, I said that we might have had some sympathy for the Bill but for the cumulative effect on motorists.

Ms Julia Drown: Will the right hon. Lady give way?

Miss Widdecombe: No, I have just given way on that point. I now want to make some progress.
I was about to say, before I was interrupted, that I was grateful to the Secretary of State for one thing—the assurance that the new charges would not be levied retrospectively. I am glad that he has said that. I take it from what he has said that, even though the hospitals could have collected the money under the 1988 powers and too often did not, there is no suggestion that that should now be recovered. I am sure that that will be welcome both to the insurance companies and to motorists.
Will the Secretary of State accept that the measure is proof positive that we ration health care services in the NHS, and that there is only a limited amount that can be done? After all, the Government have boasted, with their quaint method of accounting, that they have put £21 billion extra into the NHS, yet they still find it necessary to fine motorists £10 for the crime of needing hospital treatment. Does that not say it all? Is it not true that the National Institute for Clinical Excellence will ration treatment and services throughout our health care system?
I wonder how comfortable the Minister of State feels today. He described the Road Traffic Act 1988 as a sick law. He has tried to get out of that since then by saying that he was referring to the 1930s regulations, but his

comments were made in 1995, when the issue of the day was an order that simply increased the scale of charges for the liability incurred. So what was he then complaining about? Was he complaining that a little more money was being collected from insurance companies? So today he decides to collect a vast amount more. He described the 1988 Act as a tax on accidents, and today he seeks to increase that very tax.

The Minister of State, Department of Health (Mr. Alan Milburn): We have heard this tired old record from the right hon. Lady before. Unfortunately, it does not quite fit with the facts.
My concerns in 1994 arose from a case in which two of my constituents faced an emergency treatment fee following an accident involving their three or four-year-old daughter. I thought that the emergency treatment fee was wrong in principle, as it was levied by the hospital. I argued then that it should be abolished. I am pleased that the Government are abolishing it now. I know that the right hon. Lady is intent on torturing the facts until they confess, but she might spend a little time explaining why her Government promised to abolish the emergency treatment fee, and then failed to deliver on that promise.

Miss Widdecombe: The right hon. Gentleman refers explicitly to a tax on accidents. There is not much other description that one can give to the charges that the Government are now extending than a tax on accidents. That is what he condemned, and what he is now promoting.
On the emergency fee, let me again give some comfort to the Secretary of State, and say that we welcome that measure. We shall not seek to oppose it. We said that, when a suitable legislative vehicle, arose we would use it to abolish the fee.

Mr. Milburn: Will the right hon. Lady give way?

Miss Widdecombe: No. I have given way to the Minister on this point.
The Secretary of State has consistently said, "No new charges," but now he proposes just that. So much for Labour's sacrosanct principle of an NHS free at the point of consumption.
Lastly, I am somewhat concerned—I am open to conviction on this—that the mechanisms that are being put in place will be expensive and bureaucratic. Those who are responsible for collecting moneys have claimed that the problem is not so much the method of collection as the fact that the sums involved for individual trusts are so small compared to the bureaucracy of claiming them in the first place that there has been no incentive to claim. In what way do the proposed methods represent increased simplicity over the old methods?
We have some sympathy with the measure—[HON. MEMBERS: "Then show it."] We are pressing our amendment to a vote. We have some sympathy with the measure, but I am concerned by the cumulative effect on motorists.

Mr. Dobson: So why does the amendment state:
this House declines to give a Second Reading to the … Bill"?

Miss Widdecombe: That is how a reasoned amendment is phrased. The right hon. Gentleman has


been in the House all these years, but appears not to know that—he learns something new every day, does he not? If the Bill receives Second Reading, we shall examine in detail in Committee some of the points that I have raised today.
The Bill would result in a most unfortunate additional imposition on motorists, at a time when substantial impositions have already been levied. If the measure stood alone, it might not be so significant. The Labour Government generally seek to bash the motorist, and the frivolity with which Labour Members have treated the subject lends credence to our belief that they do not take such matters seriously.
I hope that the Minister will be able to reassure us on uninsured drivers. Why should law-abiding motorists pay twice? Why are they, uniquely, being picked on? I have no complaint about the fact that the Secretary of State is, quite properly, reviewing the collection of the charges, but why has he not reviewed the groups from whom the charges are collected? Why does he not perceive the obvious illogicality in picking on only one group of people, who use the national health service at a time when they are extremely vulnerable—in an emergency, when they are often badly injured, ill and in need of major treatment? Surely that is not the group that should be singled out for progressive taxation.

Mr. Dobson: Will the right hon. Lady give way?

Miss Widdecombe: I was about to finish, but I shall give way.

Mr. Dobson: The arguments that the right hon. Lady has adduced over the past few minutes suggest that she believes that the charge should be repealed entirely. It has been in existence since 1930; it was reconfirmed and extended in 1933; and it was last reaffirmed by the House in 1988, under the Conservative Administration of which she was a member. All we are doing is ensuring that, in future, insurers will pay the money that they should pay.

Miss Widdecombe: All the right hon. Gentleman is doing is putting an extra charge on the motorists. [HON. MEMBERS: "No, he is not"] Yes, he is: he is saying that he will raise a great deal of extra money through the proposed collection method. He is fond of referring to events that occurred under the Conservative Government, so let me point out that, when we introduced more efficient collection procedures to raise money from existing taxes, the then Labour Opposition counted that as a tax rise. Now they are getting a dose of their own medicine.
The Secretary of State is levying an extra charge on motorists, at a time when substantial charges have already been levied. The Bill is not the most sensible of measures, but I hope that it can be improved in Committee, and that the right hon. Gentleman will stop laughing at the plight of the law-abiding motorist, who will have to pay twice for the rest.

Mr. Eric Martlew: To listen to the right hon. Member for Maidstone and The Weald (Miss Widdecombe), one would think that there was a

charge on the patient, but there is no charge whatsoever on the patient. The idea that the Government will take money from vulnerable people is nonsense. What they will do is take money from the insurance companies that should have been paying it in the first place. The fact is that fewer bills will be sent out after the Bill is passed, because the Government are getting rid of the emergency charge. That is the charge that causes aggravation and distress to people who are asked for the money when they are in casualty, or who get a letter in the post. The Conservative never achieved the objective of getting rid of that charge, but the Labour Government are doing it.
I congratulate my right hon. Friend the Secretary of State on having found a slot in the legislative programme for the Bill. I am disappointed that it is to be opposed and will therefore take more time. If the Opposition, both here and in another place, were more co-operative, we could get through more legislation, but that is obviously not going to happen.
On 22 July, I asked the Secretary of State about this matter and he said that it was wrong for the insurance companies not to pay. His Department had calculated the figure at £50 million, but the Automobile Association estimated that it was £440 million. The correct amount of money will now be paid to the national health service.
The legislation will not affect all those who are injured in road accidents; it will affect only the innocent victims. For example, if I fall asleep behind the wheel, have an accident and I am treated in hospital, I obviously will not be able to claim against anyone else's insurance. In the absence of any claim, the NHS will continue to treat me for free. However, if there were a passenger in the car, he or she could claim against my insurance. The NHS will still bear the vast cost of treating road accident victims.
The charge was first drawn to my attention as a Member of Parliament when I took up the case of a constituent who had received an emergency bill. I was told that the legislation had been on the statute book for decades and that my constituent simply had to send the money to the insurance company. The bill would then be paid and there would be no problem with the no-claims bonus. Initially, it seemed to be a good way of raising money for the NHS. However, the emergency fees have caused problems, and I am glad that the Government have decided not to pursue the issue and to abolish those charges.
I have examined the real terms cost to hospitals and the amounts that they receive in compensation. In one year, my local hospital received back about £80,000 after treating 1,000 patients. I pressed my local hospital about the matter—there was a Conservative Government and the trust budget was facing a shortfall—and it managed to raise more than £100,000. However, that is not a great deal of money when viewed in the context of 1,000 road accidents.
I am pleased that the money will now go to the hospitals that treat the patients. That is a great advantage for areas such as Cumbria, where we have a sparse population but many tourists. This measure is better for rural areas as it is not fair to put the money into a general pool. My local hospital will benefit considerably. Many visitors to Cumbria—probably too many—travel by car and there is a considerable number of road accidents each year. The hospital received £100,000 last year, but the treatment of one overseas tourist in the Cumberland


infirmary cost £45,000. That puts the matter in context. In that case, the German insurance company paid the bill and there was no problem.
Although we expect this legislation to raise considerable extra money for the NHS, the reality is that the health service will never have enough money. Cumbria has done very well under this Government: we are to have a new district general hospital and there is a health action zone in the north of the county. However, my constituents realise that resources will always be scarce and it is wrong to claim that this legislation is unpopular with the general public. The Conservatives and the Liberal Democrats have picked the wrong approach—the Liberals always do.
My local newspaper, the News and Star, surveyed the population on this issue—it is called a vox pop. Nine out of 10 people interviewed thought that it was a good idea that their insurance companies—not they—should pay the NHS to treat road accident victims in the same way as those companies pay to repair the vehicles involved in the accidents. The proposal is popular. I am pleased that the Secretary of State is introducing the Bill and that it will be implemented by April. [Interruption.] I am glad that the right hon. Member for Maidstone and The Weald thinks that that is funny.

Mr. John Randall: My point is not meant to be confrontational. I know that the hon. Gentleman's constituency is in Cumbria. Does he think that the Bill's principle should be applied to people who come from outside that area to do mountaineering or hill walking because the local health service pays for their care if they are injured while taking part in those activities?

Mr. Martlew: The principle is specific to the Bill. The existing legislation, which has been in place since the 1930s, was amended by the previous Government in 1988, and all sides of the House have agreed to it. There is now some carping about the level of the charges. People are prepared to pay a little extra—that is all it will cost and if competition works properly, there might be no extra cost—through their insurance to ensure that payment is made to the NHS. If the Opposition do not believe that, they are out of tune with their electors.

Mr. Alan Duncan: Will the hon. Gentleman explain what he believes to be the difference between motor insurance paying for someone's health care and general health insurance paying for such care?

Mr. Martlew: There is a great difference. This proposal is acceptable and has been since the 1930s. Any other proposal would be unacceptable and would go against our commitments. We gave a commitment on this measure and we shall stick to it.

Mr. Philip Hammond: Where?

Mr. Martlew: We made a commitment on charges and we are getting rid of several charges for people who are affected by the legislation. We shall reduce the number of those charges by three quarters. I am sure that when hospitals receive the money, the right hon. Member for Maidstone and The Weald and her hon. Friends will not say, "Send it back to those poor insurance companies.

They cannot afford it." They will accept the situation. Conservative Members are making mischief. I shall support the Bill.

Miss Widdecombe: The hon. Gentleman continually refers to insurance companies paying. How does he think that insurance companies get money if not from the people who insure with them?

Mr. Martlew: I have already said that if there is an extra charge, my constituents will accept that it is a price worth paying to support the health service. The insurance companies should have been paying that money all along. In some cases they have frustrated the hospitals' and trusts' claims for money by not co-operating. Time and time again, we find that the Tories would sooner support insurance companies than support the national health service.

Mr. Simon Hughes: My colleagues and I will vote for the reasoned amendment in our names if it is selected by Madam Speaker or by you, Mr. Deputy Speaker. If it is not selected, we will vote for the amendment tabled by the right hon. Member for Maidstone and The Weald (Miss Widdecombe) and her colleagues.

Mr. Deputy Speaker: Order. Perhaps the hon. Gentleman was not present at the beginning of the debate when Madam Speaker announced that she had selected the amendment in the name of the Leader of the Opposition. That is the decision on the selection of amendments.

Mr. Hughes: In that case, we shall, perforce, support the amendment tabled by the Conservative Opposition because we cannot vote on our reasoned amendment. We have reservations about the way in which the right hon. Member for Maidstone and The Weald has drafted the amendment because it is rather pro-motorist.

Miss Widdecombe: Rather!

Mr. Hughes: We are unhappy about that stance. The debate should be about how the health service raises money rather than whether motorists are clobbered by the measure. I shall turn to the details of that issue in a moment.
I apologise to hon. Members for the fact that the reasoned amendment in the names of my colleagues and myself, as I have already pointed out to the Secretary of State, the right hon. Member for Maidstone and The Weald and Madam Speaker, should have read, "on the grounds that it makes provision for payment by requiring those who successfully claim compensation for personal injury sustained in road traffic accidents but not by any other means". I do not know whether that omission was caused by my handwriting, my drafting or by an error somewhere else, but I hope that I have corrected the record.
As I told the Secretary of State during the debate on the Queen's Speech, we support the abolition of the emergency treatment fee. It was too bureaucratic to collect


the charge, and the cost of collection was not worth the candle of the payment. I share the Secretary of State's view that it had an indignity about it.
If that is out of the way, this debate is about changing the rules for collecting another source of money which, as the Secretary of State rightly said, has been available for collection since the 1930s. The Secretary of State's researchers may have done a better job than me. If it is true that my predecessors and the Secretary of State's predecessors—old though he is, he is not that old—voted—[HON. MEMBERS: "Old Labour."] No, not old Labour, just old. If our predecessors voted for the measure in 1930 or 1938, that was almost two decades, or thereabouts, before the NHS came into being. Raising money for health services in those days was a whole different ball game from when we set up the national health service, which was voted for in this place by the Labour party and the Liberals and opposed by the Conservatives. We put in place a health service paid for by taxes, not charges. This debate is about whether this is a proper charge, a new charge and whether it should be supported.
I accept that, as the Secretary of State said, this is not a new charge. Therefore, I accept that in this Bill the Government have not broken any commitment not to raise any new charges to pay for the health service. It is an old charge, but it was not collected. It is a convenient source to which the Government can turn to add a bit more money to the kitty. I understand their reasons for doing it. It provides a way of raising money that is consistent with the Government's commitments.
However, it changes the amount of money raised through charges and, in that context, it is a little like the Government's announcement about raising prescription charges earlier in the year. Last year their policy was that raising prescription charges would be a tax on patients, the poor and the sick. This year, lo and behold, they raised them. This measure will mean that more money will be collected from charges, directly from the insurance companies but inevitably, as the right hon. Member for Maidstone and The Weald said, indirectly it will come from those who pay insurance companies. Insurance companies have no money of their own other than that paid to them. The Bill will increase the charges collected for the NHS from some of the people in Britain when they pay their motor insurance.
I doubt whether the motor insurance industry believes that it can do all that without putting up our premiums by a penny—only time will tell. I have never known a free lunch and I have never known insurance companies reduce charges when the bill for them has gone up. We will hear that debate in Committee and, no doubt, we will debate how much the charges might go up and when.
The reasons why my hon. Friends and I have reservations and cannot support the Bill on Second Reading are summarised in our reasoned amendment. We do not believe that it is principled to raise more money for the health service from charges. My party stands by a national health service paid for through taxation. There is a range of charges that contribute to the health service including prescription charges and appliance charges. There are also charges paid by pensioners, who are the only group in society who have money recouped if they

go into hospital because some of their pension is taken back. That does not mean that adding to an anomalous hotch-potch of charges is right. We do not think that it is.
At my party's conference this year we agreed a motion committing us to looking at all charges in the health service. I do not know the outcome of those deliberations, but, when we reach our conclusion, which will be well before the next election, we may decide to commit the party to abolishing those charges. It may be—

Mr. Kevin Hughes: The hon. Gentleman's party will have to be in government.

Mr. Hughes: We are moving towards that position as fast as the Labour party was before the general election.

Mr. Martlew: Will the hon. Gentleman give way?

Mr. Hughes: I shall give way in a moment.
As an eternal optimist and as someone who watches the political runes, I think that we are well on the way to being in government long before the hon. Member for Doncaster, North (Mr. Hughes) retires from politics, and certainly long before I and my hon. Friend the Member for Taunton (Jackie Ballard) retire.

Mr. Martlew: How much will the policy of abolishing charges cost and how much would it be necessary to increase income tax to ensure that exactly the same amount of money went into the NHS as goes in now? There will be no betterment by abolishing charges and increasing tax, will there?

Mr. Hughes: The hon. Gentleman has asked a proper question. We have asked our policy people to examine the implications this year and in future years. The hon. Gentleman is right that abolishing charges means that the money lost must be recouped. If it has to be recouped through taxation, more money must come from taxation somewhere. It may not be taxation for those at the lower end of the income scale. It may be, as my party believes, that taxpayers at the higher end of the income scale should pay more tax. That is a policy that we reaffirmed this year, a policy that is not yet supported by the Government in spite of their historic commitment to redistribution of wealth.

Ms Drown: Will the hon. Gentleman give way?

Mr. Simon Hughes: I will give way one more time.

Ms Drown: Is a possible outcome of the hon. Gentleman's party's review of charges also that it may end up supporting current charges and the method of collection that is being proposed by the Government, or is that being ruled out in his party's review of charges?

Mr. Hughes: No. The hon. Lady asks a perfectly proper question but it is mischievous.
The reality is that if we examine whether we should keep charges or lose them, everything might be considered. I have heard no voices in my party saying that we should introduce additional charges to the health service. My presumption is that my party will want to reduce charges rather than increase them. However, in


theory it is possible that things might go in a different direction. In a democratic, one-person, one-vote party, the members will decide.

Jackie Ballard: Not Millbank.

Mr. Hughes: Certainly not Millbank and certainly not through the block votes of anyone because we all come with a block vote of one.
Secondly, we are not faced with a coherent policy for reviewing charges. I would have liked the Secretary of State to make the announcement at the time of the comprehensive spending review. I would have liked him to say, "We have reviewed all the charges and for a reason that I shall now explain there is a reason behind this charge but not any other." No such luck. The charge is before us only because it happens to exist.
It is a rather funny policy. It is rather like a policy that I do not hear espoused regularly from the Government Benches: "We will support the hereditary peers because they happen to exist." The Government's charging policy is being supported only because it happens to exist. That is hardly a principled basis for keeping a policy. It would have been far better to examine all charges and ascertain whether the Government's proposal is supported by logic.

Mr. Oliver Letwin: rose—

Mr. Hughes: I hope that in a moment I shall be able to persuade the House that it is not.

Mr. Letwin: I am tempted by the hon. Gentleman's most recent remarks to ask him whether he will confirm that the Government have rather said that they will be perfectly happy to have hereditary peers, or at any rate 91 of them, because they are there in the House of Lords.

Mr. Hughes: rose

Mr. Deputy Speaker: Order. The hon. Member for West Dorset (Mr. Letwin) is following the track along which he went last night in introducing entirely extraneous matter.

Mr. Hughes: I had not dreamt of being distracted, Mr. Deputy Speaker.
Thirdly, if the Government are considering introducing charges, I flag up the question whether there are some people who use the NHS who perhaps should pay—not those who are United Kingdom residents, not nationals of countries with reciprocal arrangements with the UK and not those who come as asylum seekers and therefore ask to use NHS benefits—such as those who come to this country as income earners who are perfectly well financially endowed. They come here on that basis and yet they are treated under the NHS. There is an issue there. The Government have raised it and the previous Conservative Government raised it. It is one that seems to be outside the debate about whether UK residents should pay taxes, or those to whom we have obligations in this country.
The fourth reason why the Government's approach is problematic has been alluded to by the right hon. Member for Maidstone and The Weald. If we charge people who use their cars through their insurance, it is not a

progressive tax. The reality is that the poor pay as much as the well off in many senses. For example, those in rural areas have no alternative but to have a car. They have to pay motor insurance and if their premiums increase, they will suffer. That will adversely affect the less well off, if the charge impacts on the insurance payer at all.
Lastly, as the right hon. Member for Maidstone and The Weald said, the proposal is absolutely illogical. It is not logical that we should recover money from someone who receives compensation for being injured in a road accident, regardless of his or her responsibility for the accident, but not from someone who is injured—I shall deal only with transport—in a train, shipping or aircraft accident. Ministers might say, "You do not have to be insured compulsorily to use those forms of transport", but such insurance is required for some of them.
There is, nevertheless, no logic in claiming money from those who have been compensated for a motor accident, but not from those who have been compensated for an accident at work when the employer is obligated to ensure that employees are insured, or from those who are compensated for tripping over a footpath or in a park that the local council is responsible for maintaining and when the authority is obliged to have an insurance policy.
What about climbers, sailors or—as my hon. Friend the Member for Montgomeryshire (Mr. Öpik) will have in mind—hang-gliders who are treated wonderfully by the national health service for injuries caused because of a choice that they have made? Although people make a choice to sail, to climb or to hang-glide, if they are injured, they will not be asked to make a contribution for their treatment. There is therefore absolutely no logic in the Bill, which is simply an ill-logical means, without principle, to gain access to a pocket of money.

Mr. Syms: The hon. Gentleman is perfectly right about aircraft accidents. A few years ago, an aircraft overshot Northolt and went on to the A40, hitting cars. In such a situation, a millionaire in a private jet would not be caught by his insurers, whereas the poor person driving his or her Ford might well be caught.

The Parliamentary Under-Secretary of State for Health (Mr. John Hutton): That is wrong.

Mr. Hughes: Such examples may be wrong. However, debates on such matters should be left for the Committee stage rather than Second Reading. There will be a debate in Committee on the Bill's details, which I do not want to dwell on now. If the Bill is given a Second Reading today, as I think that it just might be, my hon. Friends will test in Committee whether the charging system proposed—if we are to have such a system—is the best one.
If we are to have such a system, the system proposed in the Bill seems to be better than the current one. It seems that flat-rate charges are better than variable ones, and that a common charging system is better than a localised one. Therefore, for as long as we shall use such a system to raise revenue for the health service, I guess that the Bill's provisions will offer the least worst option.
Ultimately, if the charges raise £100 million, it will of course be welcome—but it will hardly make a huge contribution to the health service's £45 billion budget. I only wish that the Government had proposed an overall


review—on a basis of principle and logic—of health service charges, and not simply plucked a convenient little extra off the shelf.

Mr. David Hinchliffe: I am very happy to support the measure, which is sensible and tidies up procedures that—as my right hon. Friend the Secretary of State said—have been in the system and operating since the 1930s. The system has had cross-party support, and I think that its historical and political context has been generally understood. Nevertheless, I agree with my hon. Friend the Member for Carlisle (Mr. Martlew) that the public have not fully understood the system.
Like my hon. Friend the Member for Carlisle, I have had constituents raise with me their concern about charges for emergency treatment within what they perceive to be a free national health service. Many constituents are completely unaware of fees, and are shocked when a demand for fee payment is pressed on them. In each of my 11 or 12 years as an hon. Member, I have received two or three letters expressing their concerns about the system, which the Bill will sensibly amend.
I specifically welcome, for reasons that I have already given, the Bill's proposal to remove the emergency treatment fee. I welcome also the proposal on removing from national health service providers the role of collecting money. Like my hon. Friend the Member for Carlisle, I particularly welcome the Bill's proposal on returning funds to the providers who provided the treatment.
The right hon. Member for Maidstone and The Weald (Miss Widdecombe) and the hon. Member for Southwark, North and Bermondsey (Mr. Hughes) asked about extending the principle of charging to other spheres. I do not think that any hon. Member has yet mentioned in the debate the contents of the Law Commission's 1996 consultation paper. It raised the possibility of a reclaiming scheme for other personal injuries for which damages are paid. As I said to my right hon. Friend the Secretary of State last week, in my long lost youth I played a good deal of rugby league and, as a consequence, spent a lot of time in local hospitals receiving treatment. I was well insured above the costs of any loss of time at work resulting from the injuries and made a substantial profit on each claim.
I am not suggesting backdating, but some people have asked about extending the practice to other areas, particularly those for which there is compulsory insurance. That may be tempting for the Treasury, but I urge caution, because such a scheme would depart from some important basic principles governing how our NHS has operated since its introduction in the 1940s. I am worried that extending the principle of recouping insurance payments to other areas could result in a USA-style system, which I have seen, where insurance arrangements are established for each patient before a pulse reading is taken. I am sure that we would all oppose any changes in that direction.
I have listened with great interest to the comments of the Conservatives. I am sorry that the right hon. Member for Maidstone and The Weald has left the Chamber, because I wanted to raise some concerns about what she

said, particularly the inconsistency between her arguments today and the record of the Conservative Government, who moved health provision ever more towards a USA-style system. If the Tories have a health policy, it is to move increasingly towards private insurance. She has made that clear in debates since the general election.
We should examine how the introduction of market mechanisms by the previous Government and the increased emphasis on paying for elements of health care have led to some of the problems in the national health service that the Government are trying to unravel.
I was interested in the right hon. Lady's attacks on the Government's proposals for motorists. In 1988, I served on the Standing Committee that considered the Health and Medicines Bill, which was all about introducing wider fundraising duties and powers for the national health service as part of a move towards the American-style system that the Conservatives favoured. The Tory reasoned amendment talks about burdens imposed on private motorists and complains that
these charges will apply only to motorists".
I should like to hear the views of Opposition Front Benchers on what arose from their Act in 1988. One of the first results was the imposition of car parking charges in hospitals. In a spirit of consistency with their reasoned amendment, do the Conservatives believe that the previous Government were wrong to bring about a system that penalised people using cars when they visited hospitals? Elderly people who travel to see their loved ones in hospital have to pay to park at that hospital.

Mr. Randall: Many hospitals, including that in my constituency, have tokens for those who are genuinely visiting the hospital or staying there. We had a problem at Hillingdon hospital with people parking for free and going into town, depriving others of the use of the car park. There is a way of getting around the problem.

Mr. Hinchliffe: That may be the case, but it seems inconsistent that the Opposition have tabled a reasoned amendment and made remarks bashing the motorist when the previous Government—the right hon. Member for Maidstone and The Weald was a Minister at the time—introduced hospital parking charges.
I now turn to another issue which also resulted from the policies of the previous Government. My constituency received national attention when the general manager of Wakefield health authority received from the Conservatives the national prize for innovation for introducing a remarkable scheme under the Health and Medicines Act 1988 which earned the NHS £10 a head—perhaps that is the wrong term. When someone was lying dead in the hospital mortuary awaiting collection by the local undertaker, for a fee of £10 the mortuary attendants would measure the corpse to ensure that the undertaker arrived with the correct-size coffin. That cost was passed on to the bereaved relatives—yet another charge that the right hon. Lady has conveniently forgotten, but one that gained Wakefield something of a reputation shortly after the introduction of the Health and Medicines Act.
The Conservatives also presided over the total privatisation of care of the elderly in private nursing homes and care homes. People ended up paying for services that they had previously received free from the NHS. Those charges impacted on the most vulnerable


people—as do the increasing charges for domiciliary care and the anomalies that persist today as a consequence of those charges.
I welcome the Government's resistance to calls for more charging and their response to the direction that the previous Conservative Administration were taking. I welcome my right hon. Friend's arguments against charging for GP consultations and hotel prices for NHS beds and the steps that he is taking to return the NHS to its basic principles. In particular, I welcome the massive sum of money that he and his colleagues have obtained from the Treasury; it is having an impact in my constituency and throughout the country.

Mr. John Randall: In giving the Bill a Second Reading, the House will not be introducing a new principle of NHS funding; rather, the Bill will ensure that the NHS entitlement to recover its costs for treating accident victims, which is already enshrined in law, is achieved more readily.
The NHS is currently entitled to recover the costs of treating the casualties of road traffic accidents. The difficulty has been that, to date, it has not been very successful in doing so. The Bill will attempt to change the position by shifting to insurance companies the responsibility for making payments to the relevant trust or hospital.
According to Department of Health figures produced last July, NHS trusts recovered £13.7 million from insurance companies during the financial year 1995–96. Estimates as to the sums that could have been recovered vary hugely. The Department has estimated that around £50 million could have been claimed, whereas the Automobile Association claims that the figure could be as high as £400 million.
During the financial year 1996–97, 190 trusts out of a total of 429 claimed back absolutely nothing from the insurance industry. To illustrate the diversity of claims being made, during 1996–97 the Leicester Royal infirmary raised £365,000, but Guy's and St. Thomas's Hospital NHS trust raised only £15,000 and Derby City hospital raised absolutely nothing.
It would seem that, in the light of those figures, the NHS could begin to recover fairly large sums of money previously left unclaimed. It would be helpful if the Minister would enlighten the House on the difference between the estimated sums that are not claimed, in order to give the House a realistic idea of the scale of the problem.
One reason for the apparent failure of trusts to reclaim money from the insurance companies is the perception that the current system is bureaucratic and legally complex. A Department of Health circular has advised NHS trusts to consider more carefully how they pursue claims under the Road Traffic Act 1988. Perhaps the Minister will shed some light on how far that misperception has been corrected through more rigorous enforcement of current guidelines. What improvements resulted from the circular?
Under the Bill, the Secretary of State will issue certificates to the insurance companies specifying the NHS charges that are due. The responsibility will be delegated to the Department of Social Security's

compensation recovery unit. The certification scheme, which is outlined in clauses 2 and 3, is designed to be as similar as possible to current schemes involving the unit and the insurance industry. The aim is to make the new scheme's introduction cheaper and easier, but will the Minister provide us with any Department of Health figures on the estimated costs and say what alternatives have been considered?
The initial response to the Bill has been relatively muted. The two parties that will most obviously be affected—the NHS and the insurance industry—have had different reactions to it. In the NHS, there has been a slightly different emphasis, depending on to whom one speaks. The NHS Confederation has welcomed the Bill as a way for hospitals cost-effectively to recover the money to which they are entitled, whereas the British Medical Association doctor-patient partnership and members of the Royal College of Nursing have expressed concerns about the knock-on effect on NHS funding. There are fears that the Bill will provide a precedent whereby the door is open to fund other areas of health care through insurance schemes for health-damaging life styles—from the heavy drinker to those who indulge in dangerous sports.
It is not clear why the victims of road traffic accidents should be singled out. What about any other injured individual who makes an insurance claim after receiving medical treatment? Why should the victim of a road traffic accident be the focus of recovering moneys from the insurance industry when others are immune? It would be of great interest if the Government would say what view they take on that difficulty and whether they have plans to extend the Bill's principle to funding for other areas of health care. I am sure that, even on road traffic accidents, the Government acknowledge that road users other than car drivers are involved in or even cause accidents. Are there plans, for example, to extend the system to compulsory insurance for cyclists or pedestrians? That is a genuine matter of debate, although I would not particularly welcome any such extension of the scheme.
On the Bill's implications for the insurance industry and the motorist, the Automobile Association has estimated that the increase in premiums for drivers will be higher than the Department of Health has said. The Government have produced a figure of between £6 and £9, whereas the AA has put it at nearer £10 on the average motor policy.

Mr. Dobson: For the record, the Association of British Insurers has estimated that, if the full costs are passed on to motorists, there will be a 2 to 3 per cent. increase—between £6 and £9—in the price of a policy. I assume that the ABI knows more about the matter than the Automobile Association does, as its members will have to pay.

Mr. Randall: I am grateful for the Secretary of State's intervention and his dismissal of the Automobile Association's opinion. In fact, the ABI has cited an amount as great as £20 on motorists' premiums. If there were less of a discrepancy between the estimates, that would help us to make up our minds about the Bill. The motorist will be hard pressed by a range of new charges from the integrated transport policy, in addition to the


increased costs proposed by the Bill. The motorist does not want further large increases in premiums on top of everything else.
Rebecca Hadley of the AA has said:
Britain's estimated one to two million uninsured drivers will continue to dodge the charge. It is also an unfair levy: if you fall off a ladder while cutting your hedge, the hospital would provide treatment without claiming the cost from your home insurance, so why are motorists singled out, yet again, to pick up the tab?
In light of the AA's comment on the number of uninsured drivers on the roads, it would be helpful if the Minister would tell us what discussions he has had with the Home Office about reducing the number of uninsured drivers who continue to exploit the situation. If the Bill achieves its aim, dealing with that problem will become more of a priority.
The Bill aims to make the current way of recovering money from insurance companies for traffic accidents easier and more efficient. However, the Government must say in more detail how much money the Bill will save for the NHS. How much will it cost to implement? What guarantees can be given about not extending the principle to other areas of funding? What will be the effects on the ordinary driver? What is proposed for all those on our roads who are driving without insurance?
Principally, I am asking the Government why attacking the motorist once again is their priority. Without answers to those fundamental questions, I am afraid that I cannot support the Bill.

Miss Anne Begg: I would like to take this opportunity to describe my experience of the existing legislation. Let me take the House back to a snowy January morning in 1996, when I was driving my fairly new car—a spanking red car that was only two months old—near Brechin and Arbroath as I was going to work. It was a snowy morning with a lot of black ice. Water had been running across the road and had frozen. I was tentatively driving up a narrow, winding back road—taking my time because I knew of the dangers of the road. It was a classic accident spot.
Imagine my shock and horror when I saw another driver come around the corner towards me. I could see the fear and alarm on her face, and it was obvious that her car had hit a piece of black ice. I do not know whether anyone in the House has been in the situation where an accident is about to happen, but it happens in slow motion. I could see the expression on her face as her car slid across the road. She would quite happily gone off the road and into some trees, but I happened to be in the wrong place at the wrong time. Before the impact, my last thought was, "My nice new car!" There was nowhere for me to go as her car ploughed straight into the side of my car.
I was lucky—I had my mobile phone and I quickly dialled 999 to report the accident. Before long, an ambulance was there to cart me off to hospital. It was an occasion when it was quite good that I was in a wheelchair because, in standing on my brakes to try to stop the accident, I had done something to one of my feet. It had swollen; possibly a bone was broken—I did not know. I got my wheelchair out of the car and got myself

into it. By the time the ambulance had arrived, I was mobile, but obviously something was fairly seriously wrong. Also, I had broken my sternum from wearing the seat belt. The ambulance took me to the local hospital, Stracathro hospital, where I was patched up and duly dispatched home.
At this point, I was glad that I had ticked the small box on my insurance form that ensured that I would have legal representation should I have an accident. The insurance company appointed a lawyer, who went into action on my behalf to claim some personal injury compensation.
I was able to claim a small amount to compensate for my pain and suffering, but I also had to claim back my wages for the two days for which I had been off work, despite the fact that my employer would have paid my wages in any case. As a teacher working for a local authority, I was covered by all the normal statutory sick pay arrangements, but because I was claiming personal injury compensation, my employer expected recompense for the two days' work that he did not get from me.
I expected to have to claim something to pay for hospital bills, but it did not happen. I had that expectation because, 20 years earlier, I had had another accident. I do not want hon. Members to think that I make a habit of having accidents. It was a snowy evening in March, and on this occasion I was driving down a road in Dundee when someone came out of a side road, tried to brake, did not stop and came straight across my path—another example of my being in the wrong place at the wrong time. I was collected by an ambulance and taken to the Dundee royal infirmary.
After that earlier accident, a bill arrived at my house, which I thought was to cover the cost of the ambulance. I have learnt only this afternoon, by listening to my right hon. Friend the Secretary of State, that the bill was not for the ambulance. I remember feeling alarmed that I had to pay for the ambulance, until someone told me that the bill would be met by the other person's insurance.
Therein lies the problem: two different health authorities, and two almost identical accidents, but in one I—or the insurance company of the person who caused the accident—was not charged, while in the other a charge was made. That is the anomaly that the Bill will put right. The power already exists, and is exercised in some areas, to charge for hospital treatment resulting from an accident; but it is used sporadically and inconsistently. It is used by some health authorities on some occasions and by others not at all.
What is the point of legislation if it cannot be enforced and the money cannot be recouped? That is why I welcome the Bill. It will make the recovery of costs much easier and there will be much greater consistency. It is different from existing legislation because of the compensation recovery unit, which will take the responsibility for recouping the money for the hospital out of the hands of the individual and put it squarely on the shoulders of the insurance companies. The law will be more coherent and therefore much better.
I welcome the Bill because it will create a much fairer system. It will apply to everyone equally and I hope that, as a result, the health service will continue to be able to put extra resources in the areas of greatest need, improving accident and emergency treatment, modernising the equipment in ambulances and reinvesting funds in the health service to make it the jewel in the crown that makes us so proud to be British.

Mr. Robert Syms: In such an interesting debate on the subject of charging in the national health service, one can confidently predict that each side will accuse the other of being inconsistent. On both the Government and the Opposition Benches we have a history of arguing certain cases. Car parking charges are one of the topics that have already been mentioned. Consistency may not ring out from either side of the Chamber tonight.
Regardless of the existing law, the NHS charges have not been collected. If the Bill introduces a more efficient collection system, motorists will ultimately have to pay via their insurance companies. In effect, the Bill brings about an indirect tax rise, against the background of major increases in motoring costs initiated by the Government, as my right hon. Friend the Member for Maidstone and The Weald (Miss Widdecombe) argued.
Everyone contributes to the NHS through general taxation. Motorists will, in effect, be charged twice. Having paid through general taxation, they will be expected to pay again through their insurance. It is estimated that the Government's proposals will cost motorists an extra £10 a year in increased premiums. Seen in the context of £9 billion of extra motoring taxes, it is clear that many motorists will find the additional cost difficult to meet.
During the debate, the Opposition will seek assurances that the proposals are not the thin end of Labour's charging wedge. It is easy to claim that increased charges are justified in one part of the NHS, but good arguments can be made for higher charges for other NHS services.
The Bill has implications for bureaucracy. Additional money may well be raised, but that will entail costs, as 50 people will be employed in the collection unit.
Insurance premiums will rise by about £9 a year. As my hon. Friend the Member for Uxbridge (Mr. Randall) noted, the Automobile Association estimates a £10 increase, but that remains to be seen. The fact that costs will be absorbed by the Motor Insurers Bureau means that the uninsured may be paid for by the insured. That is not compatible with natural justice. Higher insurance premiums are hardly likely to increase the number of motorists who take out insurance. The Association of British Insurers estimates that uninsured drivers will cost motorists £250 million in 1999. The Bill could increase that sum substantially.
Many motorists' costs are paid by businesses, so business costs will rise. There are 1.6 million company cars. The additional burden on business will have to be financed from trading.
The charges could be judged to be an unfair levy. Motoring in the United Kingdom is already more expensive than elsewhere in Europe.
Anomalies will inevitably arise, and perhaps the Minister will respond on this point at the end of the debate. I mentioned earlier the example of an aircraft careering off a runway into a road. If someone falls off a ladder in his home, there would not necessarily be a claim against his home insurance. The case of cyclists has been mentioned. Other examples are that of a ferry sinking or a train or aircraft crashing.

Mr. Andrew Dismore: Aircraft and shipping accidents are covered by international conventions, so a

Government could not legislate for those cases, even if they wanted to do so. The Athens convention deals with shipping accidents and the Warsaw convention with aircraft accidents.

Mr. Syms: The hon. Gentleman makes an interesting point. I am sure that such issues will be explored more fully in Standing Committee, on which I may volunteer to serve. The Bill creates a regressive tax without regard for whether someone is rich or poor. Indeed, some poorer households pay rather more of their income in insurance than do some richer households.
The Bill also raises questions about the future funding of the national health service. If we introduce the principle that motorists should contribute through their insurance companies, we shall have to deal with arguments about why that should not be so for smokers, drinkers or the overweight. Self-inflicted injury has been mentioned. Those who take part in dangerous sports might also be affected. We must address the anomaly of having a charge for motorists—probably because there is already a substantial insurance market which can be tapped—while there is no charge in other areas. There is also concern about extra bureaucracy.

Ms Drown: Did the previous Government point out that anomaly during discussion on the Road Traffic Bill in 1988? Can the hon. Gentleman distinguish between the compulsory insurance required by people who drive cars and non-compulsory insurance, which applies to some of his other examples?

Mr. Syms: The hon. Lady makes a good point. Motoring insurance is compulsory, although not everyone takes it out. A number of people caught in accidents are not in fact insured, and one of my problems with the Bill is that it fails to address that situation. The burden will fall on law-abiding citizens who conform to rules, regulations and laws, and who may have to pick up the tab for the bad apples who are uninsured.
The principle of insuring oneself for certain activities is recognised. People take out insurance for various sports.

Miss Begg: Will the hon. Gentleman clarify whether he is suggesting that, because some people break the law by not taking out compulsory insurance, we should not accept the Bill?

Mr. Syms: I am not suggesting that; I am merely saying that it is a fact of life that many people who should be covered by motor insurance are not covered. Under the Bill, the Motor Insurers Bureau run by the insurance companies will have to cover claims for those people who have not done their duty.

Miss Begg: Should we, then, frame legislation to take account of those who break the law or do not fulfil their obligations? Is that what the hon. Gentleman is saying?

Mr. Syms: No, that is not my point. Many people are insured. The Government's proposals will hit law-abiding citizens, who have already been hit by increased motoring taxes, including an increase in fuel taxes. The Bill does nothing to deal with uninsured drivers, and we should put


more emphasis on making sure that they are insured, and on punishing them if they are not. I am sure that hon. Members on both sides of the House will agree with that.
My more general point is that to argue for the principle that drivers should pay through their insurance—compulsory or otherwise—is to set off on the slippery slope of arguing the same for other, more voluntary, activities. In rural areas, people need cars, and most Members of Parliament need cars to conduct our business.

Mr. Gareth R. Thomas: May I bring the hon. Gentleman back to the point made by the hon. Member for Uxbridge (Mr. Randall) about great variations in the amounts that hospitals claim? The reason suggested was the complexity of the process. Does the hon. Gentleman agree that the Bill is excellent, in that it will simplify the process and help to eliminate variations in what is claimed around the country?

Mr. Syms: We shall have to test that point in Committee to see whether the Government's intentions—with some of which I agree—will have the planned results. Aspects of the Bill are positive, but many questions will be raised as the Bill progresses. There are concerns about the precedent being set, which may affect other areas. As a Conservative, I believe that the NHS must be basically free and paid out of national taxation. Income can be supplemented in one or two ways, but we all know that there is no effective way to pick up the NHS bill, except through general taxation.

Laura Moffatt: There will be a huge cheer throughout national health service trusts today when staff learn that the Bill has set off on its passage. Anyone in the NHS who has had to collect the £21.30 charge will tell hon. Members what nonsense that was. The Bill only makes possible what should have happened already. It contains nothing new, and it breaks no principles. Anyone who claims that a new principle is being introduced is neither right nor honest.
Is it reasonable to expect hard-pressed NHS staff to chase small sums? Those staff become completely disillusioned, dropping the chase when they have had enough. My local trust serves part of the M25, and it has to deal with lots of accidents, but it raised only £70,000 last year from the charge. Two people had to be dedicated to collecting small sums, and they were driven into the ground and became fed up. It is little wonder that some trusts paid heed to companies that offered to collect the debts, raising cash for the trusts, but taking a cut for themselves. That is clearly unacceptable.
However, matters are even worse than that. Some companies offer to look into the people involved in accidents, and then to organise retrospective insurance. The company then gets a cut for the hospital, and for the person who is making the claim. Tacky, nasty arrangements are being made over funds that should by right go to the NHS. I am glad to see the back of all that, and I look forward to putting a stop to companies making money from a difficult situation.
Charging should be in the hands of people who know what they are doing. The compensation recovery unit is used to dealing with such matters.

Mr. Letwin: How successful has the compensation recovery unit been? What percentage of claims sought over the past five years has the unit managed to obtain?

Laura Moffatt: Clearly, I am not able to answer that. I can answer only for constituents who have experienced the work of the compensation recovery unit, and who have had no complaint about the ways in which they were asked to pay back benefit that they had received while waiting for claims to be resolved.
The compensation recovery unit is used to dealing with such matters. I hope that patients and hospitals will see little evidence of administration, and that the emotive subject of money need not be raised with people at difficult times. I trained as a nurse with my local trust, and I worked in the accident and emergency department, in which everyone had an opportunity to work, both during and after my training. It is awful to have to tell a patient that he or she may be charged a levy, and that we need a name and address so that we can make the charge. False names and addresses are still given to hospital staff, and that is clearly unacceptable.
The hon. Member for Uxbridge (Mr. Randall) mentioned the response of the Royal College of Nursing. I was interested to hear the hon. Gentleman say that the royal college was concerned, as it very much welcomes these moves. It produced two pages welcoming what the Government are trying to do, and its one small word of warning concerned ensuring that the principles were not taken further, which would be my warning too. I can support the measure only because compulsory insurance is involved, and I support it wholeheartedly. We will stick to that principle. The Royal College of Nursing, as a caring organisation, is right to say that we must be sensitive when we are claiming money from people who have been involved in difficult and horrible situations. I do not want the principle to be extended to other accidents.
I listened with interest when my hon. Friend the Member for Wakefield (Mr. Hinchliffe) talked about insurance and said that he would be covered if he had an accident. That would not be true of my three sons, who play for Crawley rugby club. The club encourages a sporting activity that enables our young people to join in, have great fun and keep fit. The last thing that I want is to cause them difficulty. The principle must rest there; it would not be acceptable to take it further.
I support the Bill because motor insurance is compulsory and the money will go back to the NHS, as it so rightly deserves. As a nurse in the NHS for 25 years, I have been waiting for such a measure. Staff are involved in issues with which they do not feel comfortable. The Government say that they will do something about that. They will ensure that staff do not have to be involved and that the NHS merely needs to know the names, addresses and types of treatment that have been given in a hospital. They will take the matter out of the nurses' hands, which will clearly be music to the ears of people who work in the NHS throughout the land.

Mr. Randall: Given the hon. Lady's experience as a nurse, does she think that the measure will involve more paperwork for nursing staff?

Laura Moffatt: I can envisage only a reduction in paperwork. The hon. Gentleman should speak to those working in his local trust. In mine, two people have to spend most of their day chasing small sums. There will be a great reduction in the amount of paperwork. The job will be done elsewhere, by people who are used to doing it, which seems to be the only way forward.

Mr. Randall: I thank the hon. Lady for giving way again. She is most kind. With respect, I accept, as I said in my speech, that the money that trusts get back varies greatly. Under the Bill, will there have to be paperwork for all, or nearly all, patients who have been involved in a road traffic accident—paperwork that will have to be sent to the central collection point?

Laura Moffatt: Perhaps the hon. Gentleman has not noticed, but there is paperwork when most patients are admitted to an accident and emergency department. That work has to be done—there is no question about it—and it is the way in which it is done that matters. Another authority will deal with it further and the staff will be relieved when they hear that they will no longer have to pursue claims. The Bill is about bringing fairness back into the system. If a Labour Government are about anything, they are about fairness. Military hospitals have been included in the provisions of the Bill and will now be able to claim money. They will get the money that is due to them.
The Bill is a fitting tribute and a fitting approach to the national health service in its 50th year. I am glad that the Labour Government are taking us along that path and ensuring that the NHS gets the money that it so rightly deserves. NHS staff throughout the country will be grateful.

Mr. Oliver Letwin: With your eagle eye, Mr. Deputy Speaker, you will have noticed that I have been translated not merely from the Front to the Back Bench—I hope temporarily, for the purposes of this debate—but to the very Back Bench, as I would not want my remarks to constrain or embarrass my right hon. and hon. Friends on the Opposition Front Bench in any way.
I must begin by admitting that I am becoming something of a "Dobsonist", or perhaps, a "Dobsonite". I am startled by the magisterial way in which the Secretary of State is gradually building the case for the privatisation of the national health service—a case that he and his colleagues spent their time in opposition explaining that they regarded as an abomination.
When I was new to the House, my first parliamentary question was to the Secretary of State. I wanted to know whether he recognised that, in the first measure proposed by the Government for the NHS, he was paving the way for the privatisation of clinical services. The right hon. Gentleman, with his usual charm, grinned slightly and evaded the question wholly, since when it has become evident in the popular press and elsewhere that that was indeed the tenor of the measure concerned.
The Bill was presented as entirely uninteresting by the Secretary of State, who went out of his way to diminish the interest and importance of his own measure. I have not been long in the House, but I cannot recall an occasion on which a Secretary of State made so brief and so

low-toned a speech on Second Reading—a speech so calculated to induce silence, and possibly sleep, on the Benches behind and opposite him. He intended to put us to sleep so that we should be pleasantly anaesthetised, to use a health service metaphor, and should not notice that there was anything remotely interesting in this legislation.

Ms Drown: Does the hon. Gentleman recognise that the Bill is relatively simple and involves simple principles? Is my right hon. Friend the Secretary of State not to be highly commended for not speaking longer than necessary, since we have many matters to discuss in the House?

Mr. Letwin: As I said at the beginning of my speech, I am increasingly an admirer of the Secretary of State and I certainly do not want my remarks to be taken as an accusation against his acumen. I hope that by the end of my speech, the hon. Lady may be persuaded that, although the Bill is simple in the sense that it is short, it does not by any means involve simple principles. In fact, it probably involves the most subtle principle to be connected with the NHS and it constitutes one of the more important measures to come before the House this Session, as will probably come to light gradually in the next five, 10 or 20 years.
I shall explain. The fundamental question about health payment—not the administration of the NHS or the way in which people are cured—which has been a vexed political issue for almost half a century, is not whether there should be charges at the point of use. No major political party has advocated that since the war and, in large part, no party has advocated it since the 1920s. Everyone has aimed at a health service that is free at the point of use. The great debate—sometimes open and sometimes covert, sometimes pursued intelligently and sometimes with partisan zeal and much less intelligence—has concerned whether the health service should be insurance or tax based. Members on both sides of the House will recognise that that has been the serious issue that people have pondered, debated and failed to resolve.
The measure before the House is extremely interesting. It appears to extend the tax base for payment for NHS services. It has that appearance because it so happens that under the laws governing motoring, insurance for motorists is compulsory, so Labour Members have been able to argue that this is a special case—the Secretary of State did not bother to do so, so keen was he to avoid the issue altogether—and have salved their consciences, so to speak. The hon. Member for Crawley (Laura Moffatt) salved her conscience by explaining that this was a special case, quite unlike all the other cases that she did not want to see flow from it, because motoring insurance is compulsory.

Laura Moffatt: The hon. Gentleman says that we are salving our consciences by saying that because compulsory insurance is involved, the Bill is easy to justify. Can he cite any other compulsory personal insurances in the United Kingdom that might relate to the Bill?

Mr. Letwin: No, but I fear that I will alarm the hon. Lady a little by explaining that the distinction that she has erected will be subject to an onslaught from the Secretary of State.

Mr. Duncan: I suggest that my hon. Friend start his list with employer liability and local authority liability.

Mr. Letwin: With his customary acuity, my hon. Friend is right. There are other such cases, but my argument goes well beyond the cases where there is already compulsion.
The hon. Member for Crawley argues that this is a special case. My hon. Friend the Member for Rutland and Melton (Mr. Duncan) pointed out that it is not so special, but there is a restricted set of cases that involve compulsory insurance. Labour Members have effectively argued that compulsory insurance schemes through which the NHS seeks to recover its costs from insurers are de facto taxes. This is another sort of tax, but one that happens not to pass into the Consolidated Fund but directly to the NHS, if that is indeed the case; I plead ignorance on the point. I find it a little odd in terms of Treasury theology that it should be so designated but perhaps it is. If so, it is all the more interesting because that would suggest that it is not quite a tax. If it were seen by the Treasury as a tax, it would enter the Consolidated Fund. The Treasury therefore regards it as a charge, but the hon. Member for Crawley and others would argue that it is a de facto tax because it is raised from an insurance company in a case where the insurance is compulsory.
The problem with that line of argument from the Government's point of view is striking because we must ask why compulsory insurance is applied only in a very select group of cases, in particular, motoring and the two others that my hon. Friend the Member for Rutland and Melton mentioned. Why is compulsory insurance so restricted in its application? The answer is that it happens by historical accident to be rather restricted. Now enters upon the scene the majestic figure of the Secretary of State, with his logic and his needs.
The Secretary of State intends to pile large sums that the Chancellor of the Exchequer does not have, and will have less of in due course, into the NHS. He argues—and has introduced a Bill to this effect—that it is legitimate for the NHS to charge the insurers of people who suffer from accidents the cost of caring for them because the insurance involved is compulsory. It is at that point that he will ask the Home Secretary to do something that is perfectly rational under that rubric or logic—to expand the scope of compulsory insurance.
It is rational to propose that anyone engaging in an activity with a high chance of leading to medical care costs should by compulsion be insured. It is rational because it covers a social inequity. If they are honest, Labour Members will admit that as much as would Conservative Members. It is equitable to suggest that people who decide to do something dangerous should not impose additional costs on the rest of the community. It follows that if the Secretary of State believes that the right way for the NHS to recapture the costs from the right people is to make insurance compulsory, the Government will argue for making such insurance compulsory for a wide range of activities.
The more I think about the matter, the less I can see the slightest objection on the part of the Government to the widening of compulsory insurance. Some Conservative Members would object to a vast widening of compulsory insurance on libertarian grounds. It may well be that my hon. Friend the Member for Rutland and Melton would, because he is one of the most noted of the libertarian tendency of Conservative Members—perhaps its most distinguished exponent in print. Among Labour Members, I see no libertarians. I have heard no such logic or rhetoric from them so far, and do not expect to hear

any before the Government's period in office ends, to suggest any objection to a vast application of compulsory insurance across a wide range of activities.
Such a course would be consonant with Ministers' desperate efforts to prevent people from killing themselves by smoking. The Government specialise in trying to deal with what they regard as the problem of individuals taking risks that they should not take. Why else spend large amounts of public money trying to persuade people not to smoke? Why else does the Minister for Public Health spend her time circulating the heads of the royal colleges and desperately assuring them that the single most important thing in the health service is preventing people from smoking? Why would it not be a natural extension from that to get the Secretary of State to agree to something that would be introduced as an unimportant, obvious little Bill to which we need not pay much attention, and would create a compulsory insurance scheme for smokers? Labour Members could argue that, de facto, it was a tax if the NHS could recover the cost of cancer treatment from a compulsory insurance scheme for people who smoke. I believe that treating cancer is one of the major costs of the NHS, although I am not an expert. That logic could be extended across a vast range of activities.

Mr. Hugh Bayley: Where is the evidence?

Mr. Letwin: The hon. Gentleman asks where the evidence is. We have an interesting dialectic here, similar to that which we find in relation to the European Union. First, we get an unimportant little measure about which we are told not to worry. Secondly, there is an accusation that it may lead to greater things. Third comes the riposte, "Where is the evidence?" Then, it comes true and we are told, "Goodness me, you must have noticed that at the beginning." I fear that what I am describing is a logic, and logic is powerful. Even in this Government, it captures people.

Ms Drown: I might accept that this could be the start of a huge, fantastical operation by the Government if the Bill proposed new charges, but it does not. The charges have been in place since 1930. Given that and the fact the hon. Gentleman's Government in 1988 discussed the matter and reinforced the charges, he is on very weak ground.

Mr. Letwin: That is the brilliance—

Mr. Deputy Speaker: Order. This is not an abstract debate but one on the Second Reading of the Road Traffic (NHS Charges) Bill. It would be helpful to hear a little more about that. The hon. Gentleman has travelled rather far from the core of the subject.

Mr. Letwin: I stand corrected and shall swiftly bring my remarks back to the Bill, but the hon. Member for South Swindon (Ms Drown) illustrates the brilliance, power and subtlety of the Secretary of State's mind beautifully. He has chosen a case in which he can argue that he is not even doing what he is doing. By vastly increasing the take in circumstances where he can find an ancient peg, he can argue that the Bill is not a Bill at all but merely a tidying-up. There were moments in his


speech when I doubted that he was introducing a Bill because he seemed to be talking about an administrative measure that would not have required parliamentary approval.
The Secretary of State is, of course, making a major change. He is introducing legislation; he is occupying the time of the House to go through First Reading, Second Reading and so forth precisely because he is trying to raise a large amount of money. He is doing something that will have an impact in precedent. We may hardly believe it any more, but legislation passed by the House is important in the development of the way in which people think about the subject of the legislation. If legislation is introduced about the NHS that has the effect of raising a large extra sum from insurance, the logic that I describe becomes all too easy to apply.
To move back to the remarks that I was making before I gave way—but very much in the context of the Bill, Mr. Deputy Speaker—I want to argue that the extension of compulsory insurance under the Bill is a major conceptual change in the allocation of NHS payment and funding. Ultimately, every activity carries risk. The mere act of breathing is risky. Compulsory insurance could easily be widened to the point at which it covers all the costs of the NHS. The Secretary of State knows that; his officials know that; his Ministers know that. If and when the Secretary of State begins to build what I suspect he privately intends to build on the basis of this measure, Labour Members will be surprised to find that this little, apparently unimportant Bill was a paving Bill in the most exceptional sense—a conceptual paving Bill.
The Bill is reminiscent of much else that the Government are doing. In many cases, they are slowly beginning to persuade members of their own party to accept vast changes to positions held only by the Conservative party before now by persuading them to accept things that are apparently innocuous. I fear that Labour Members have illustrated beautifully this afternoon exactly the tendency that the Secretary of State hoped that they would illustrate, namely, the tendency not even to notice that there lies within the Bill the seeds of something that they at present do not wish to see grow into a tree.

Mr. Gareth R. Thomas: I have been struggling to follow the logic of the hon. Gentleman's argument. He now says that the Bill is some sort of paving device for new charges. Although he was not a Member of Parliament at the time, I am sure that he supported the Road Traffic Act 1988. Why was that not the paving Bill for wider charges?

Mr. Letwin: I cannot he said to have supported the 1988 Bill because I had no idea that it existed. Had I been a Member of Parliament, I might or might not have supported it. The reason why it is perfectly appropriate that my right hon. and hon. Friends should have tabled a reasoned amendment this afternoon is not that the Bill is in principle objectionable, but that the explanation that has been given of it and the logic that has been advanced as lying behind it are wholly beside the point. The truth has not been brought out. It is the role of the Opposition to oppose that which they need to oppose and to bring out the real character of measures.
I believe that the real purpose of the debate this afternoon is precisely to illustrate to the public that the Bill has far wider implications than has been admitted to

them and that the Bill has been defended on a basis that is not open or honest with them. It falls to the Government to admit what lies behind the Bill. Then perhaps in later stages, Labour Members may have their own doubts about the wisdom of this measure, even if Opposition Members have, as my right hon. Friend the Member for Maidstone and The Weald (Miss Widdecombe) said, some sympathy with the principle.

Ms Julia Drown: In following the hon. Member for West Dorset (Mr. Letwin), it might be helpful if I bring the House back to reality. Although his speech was interesting, and perhaps it used up some useful time of the House, it has not been useful in making progress on the Bill.
I am disappointed that the Opposition do not support the Bill, but perhaps it serves as a useful example of the difference in priorities between the political parties. While the Labour Government believe that the NHS should get the funds to which it is entitled, the Conservative party seems more concerned about letting insurance companies off the charges that they have been set up to cover. Other Opposition Members seem more concerned to discuss the philosophical purities of differing charging regimes.
The hon. Member for Southwark, North and Bermondsey (Mr. Hughes), who is not in his place, suggested that £100 million was not a lot out of the £40 billion that the NHS needs every year. I suggest that £100 million can make an awful lot of difference to the NHS. If the hon. Gentleman does not want that money for his constituency, I can guarantee him that my constituents could well use the money for their health services.

Dr. Evan Harris: The hon. Lady must accept either that a significant amount would be saved which could replace money raised from income tax for the NHS or that too little would be raised to re-establish the principle—I take the point that the Bill re-establishes something that has already been legislated for—that patients should pay towards their care. In our reasoned amendment, however, the Liberal Democrats propose as a fairer way of funding the NHS in general than through patient charges.

Ms Drown: I do not accept that. I see the charges as money to which the NHS is entitled and has been entitled since 1930, when the legislation was first introduced. The NHS has not been collecting all that money, but the Government are setting up the proper administrative arrangements to ensure that the money goes to where it is needed in the NHS.
I am pleased to be able to speak on the Bill because I am one of the few people in the House who has personal experience of managing the existing system under which the NHS can reclaim from insurance companies some of the costs of treating people who have been injured in road traffic accidents. My brief experience was instructive and I remember it well. Two things stand out in my memory and both of them lead me to welcome the Bill.
First, I remember how inappropriate it seemed to visit the accident and emergency department as an administrator, trying to establish which of our patients were there as a result of a road traffic accident and which had been injured in other ways in order to set up the appropriate paperwork


for road traffic accident victims. The other hospital staff were rightly concentrating on giving their patients the best clinical care that they could; neither patients nor staff wanted to be disturbed at that time by what they saw, reasonably in my view, as intrusive bureaucracy. The existing system for reclaiming the treatment costs of road accident victims makes such intrusion inevitable by putting the onus on the hospital to establish not only which of their patients have been injured in road accidents but a series of details about the accident.
The principle that the NHS should be able to reclaim some of the costs of providing medical treatment to people injured in road accidents is well established. The Road Traffic Act 1930 introduced the charges, which have been levied since 1934. Motorists are covered by their insurance for those costs yet those charges are little understood by motorists or even Members of Parliament. Motorists are compulsorily insured, and that creates a distinction between the charges set up in 1930 and other possible charges that have been mentioned by right hon. and hon. Members.
Of the charges covered by the Bill, the emergency treatment fee—currently £21.30—is the most unpopular as it is payable by the vehicle user in an accident regardless of who is at fault. The Government intend to abolish that charge for hospitals, and I congratulate them on that. Its abolition will be welcomed by the NHS, motorists and insurance companies alike. It makes sense for everyone involved to concentrate on the payments for out-patient and in-patient treatment.
Over the past 50 years, NHS administrative staff have been trying to collect those funds—often in difficult circumstances. Staff collecting those sums have had to deal extremely sensitively with patients. It is only right that the House congratulates them and the administrative and other staff who have managed a difficult administrative system in a professional and sensitive manner. The Government's proposals would shift the onus of collecting payments from NHS hospitals to insurance companies. In doing so, those difficult situations can be avoided and more money spent on what is important—NHS care.
My second abiding memory of running the existing system is of how complicated and bureaucratic it is. I remember the forms, the checks and the chasing letters—they were almost charming in their detail. I also remember the filing cabinets and the frustration of chasing bills, in some cases for relatively small sums. The only thing missing from the overall Dickensian impression was a quill pen. I applaud the Government's determination to find a way to reclaim some of the cost of treating road accident victims that cuts the mass of paperwork in hospitals.
The difficulty of operating the current system has led many hospitals to reclaim less of the cost of treating such victims than they were entitled to under existing legislation. That inevitably means that there is less NHS money available to treat patients. The sensible way forward, of abolishing the emergency treatment fee for hospitals and properly recovering the money due for patient treatment, will let the NHS see the wood for the trees, and contrasts starkly with the actions of the previous Government, who merely introduced measures to increase

the piles of paper in the NHS. I welcome the Labour Government's steps to make additional money available to the NHS and to reduce paperwork.
I have three questions about the implementation of the proposed schemes which I hope will be considered during the Bill's passage. First, there is the question of transitional arrangements. On 2 July last year, my right hon. Friend the Chancellor of the Exchequer announced that steps would be taken to recover the money due to hospitals in respect of the treatment of people injured in road accidents. I understand that the new system will cover treatment given to road accident victims from that date, but if the Bill is passed, it will still be some time before guidance can be issued to hospitals and insurance companies setting out the precise details of the new system. If the Bill becomes law, I hope that the Government will make careful arrangements for cases arising between 2 July 1997 and the time when the new guidelines are issued. There will be scope for confusion and double counting in respect of such cases, so care will be needed to ensure that confusion is minimised. Some hospitals will have already billed for road accident treatment since 2 July 1997, whereas others will not. Clear guidelines are needed on who is to claim what money, from whom and when it should be claimed.
My second question relates to the nature of the records that hospitals will be expected to keep under the new system. Although I welcome the Government's aim of cutting down NHS bureaucracy by requiring insurance companies to initiate and follow through payments to hospitals, it is important that steps be taken to ensure that the new system succeeds in reducing bureaucracy. I presume that insurance companies will not simply be left to get on with the job of administering the system without checks. There will have to be incentives to ensure that the companies comply with their new duties and make all the payments they should. However, if the operation of the new system requires hospitals to keep detailed records of which of their patients have been injured in road accidents and the exact cost of their treatment, there is a risk that the new system will simply replicate the troublesome and time-consuming bureaucracy of the existing system.

Laura Moffatt: Does my hon. Friend agree that, in addition to all the difficulties with collection that she describes, there is a seven-day limit on the time in which a claim can be made, which adds to the bureaucratic nightmare suffered by administrators?

Ms Drown: The system can certainly be described as a nightmare, because of the forms and bureaucracy resulting from existing legislation. That is why I urge the Government to pay close attention to ensuring that any new system results in the NHS receiving the money to which it is entitled and in a genuine reduction in paperwork and hospital administration.
My third point relates to the fact that the Government have rightly stressed the importance of encouraging innovation in the NHS and of making the best use of hospital beds. Care in the home has been emphasised as an alternative to hospital treatment—an alternative that many patients prefer. The Bill allows the NHS to recover from insurance companies the cost of hospital treatment given to people injured in road traffic accidents. In 1930, when the Road Traffic Act was introduced, I suspect that no thought


was given to alternatives to treating people in hospital and that the emphasis on acute hospital care rather than community care was even stronger than it is now.
Given that motorists are insured for the cost of NHS treatment resulting from road accidents, should not the Bill reflect the modern reality of the NHS and allow the cost of treating road accident injuries to be charged whether treatment takes place at hospital or in the home? If that provision is not made, an incentive will remain for the NHS to treat road traffic accident patients in hospital or at out-patient clinics, instead of allowing them to be treated at home. It is illogical to say that the cost of treatment should be recoverable when that treatment is given in hospital, but not when it is given in the patient's home, for example, by a physiotherapist or district nurse. I urge the Government to examine the possibility of amending the Bill to enable the recovery of the cost of treatment given either in hospital or at home. That would be wholly appropriate given the shifts in the culture surrounding hospital and non-hospital care.
I congratulate the Government on their sensible proposal, which will be welcomed by hospital staff, both clinical and administrative. I hope that the points I have made will be addressed during the Bill's passage.

Dr. Evan Harris: Although Liberal Democrat Members found the principle of the Bill quite attractive and were tempted to support it on Second Reading, and various minor parts of it in Committee and at later stages, we have set out our objections to the principles behind the Bill in a reasoned amendment.
We welcome certain of the Bill's provisions, such as the abolition of the emergency treatment charge, which was, and is perceived as being bureaucratic and upsetting to many patients. However, we have serious concerns about some of the principles that the Bill reflects or that it re-establishes from existing legislation, which overcome the advantages contained in those welcome provisions.
Our amendment states our concern that the Bill
makes provision for requiring those who successfully claim compensation for personal injury sustained in road traffic accidents, but not by any other means",
with the result that the measure appears to operate in a vacuum. We should be grateful if the Government gave a clear statement of the principles behind the way in which they want to treat co-payment and patient charges. Secondly, the Bill
proposes no coherent policy for raising or reforming NHS charges or for making them fair".
We still await detailed clarification of whether the Government believe that current prescription charges, as an example of co-payment, are fair in their operation; whether there are any proposals to make them fairer; and what is the future of those sort of co-payments.
Our third objection is that the Bill
moves public policy and practice further away from the principle of paying for the NHS from general taxation".
That point has been made by hon. Members on both sides of the House, in particular by the hon. Member for

Wakefield (Mr. Hinchliffe). Later in my speech, I shall return to the points he made. Our fourth concern is that the Bill
contains no mechanism for protecting those on low incomes against increased insurance costs"—
small though those compulsory insurance costs may be. Finally, we are concerned about the fact that the Bill
adds to bureaucracy without any sufficient compensatory benefit.
Such compensatory benefit would include clarification of some of the areas I have mentioned.
Our approach must be contrasted with that of the Conservatives. We can see from their reasoned amendment that much of their opposition to the Bill—apart from the Oppositionitis from which they are suffering—relates to their love of the motor car. The Opposition's reference to the motorist in their reasoned amendment might suggest that their love of the motor car is at least as great as, if not greater than, their love of the principles upon which the NHS was founded. I shall take this opportunity to explain our concerns about how the legislation may affect NHS founding principles.
We accept that, although the Bill does not introduce a new principle, it re-establishes an existing one. The Government had the opportunity in this Bill to abolish both the charges that apply to road traffic accident patients, but chose to abolish only one. Therefore, it is impossible for the Government to ignore the fact that they are re-establishing a principle that they had the opportunity to remove.
That principle which they have chosen to retain is that income for the NHS can be raised from patients. My hon. Friend the Member for Southwark, North and Bermondsey (Mr. Hughes) expressed concern about that matter earlier. The Secretary of State admitted that there will be an increase in the cost of motor insurance. Estimates of that increase range from £10—the figure suggested by the Opposition—to a lesser figure favoured by the Government. I am sure that if their own estimates were revised upwards the Government would opt for talking of an increase of £9.99, rather than £10, in the interests of good public relations.
That insurance increment is regressive as it will be compulsory and will generally have no regard for the income of the person seeking to take out car insurance. Everyone will be affected equally. That is not the case with the current main source of revenue for the NHS: income taxation. We believe that the principle of fairness should be upheld in all NHS policy. That is why we are concerned about the perpetual increases in prescription charges and why we went to the election calling for a freeze in those charges prior to a review. The current system has a regressive effect at the margins for those who just fail to qualify for exemption from prescription charges.
We are also concerned about where the process will end. Some hon. Members have tried to make reassuring comments, but we are not convinced. If the charge is restricted to compulsory insurance, it will not apply to injuries incurred during sporting activities where there is no compulsory insurance. My hon. Friend the Member for Southwark, North and Bermondsey asked whether the Government will soon introduce legislation to recover charges arising from employer liability—which is compulsory in many areas—as a result of industrial accidents; or from local authority liability that currently applies to injuries incurred through the negligence of local authorities.
A further example comes hard on the heels of the interesting and thought-provoking speech by the hon. Member for South Swindon (Ms Drown). If the key issue is that insurance is compulsory, what will happen to those with compulsory buildings or insurance for mortgages? What will prevent the Government from introducing legislation to charge the victims of house fires, through their buildings insurance, for the cost of expensive burns treatment? The Liberal Democrats will not be satisfied until the Government confirm that the measure will stop at this point and not affect other forms of compulsory insurance—whether that be mortgage insurance or car insurance.

Ms Drown: The legislation refers to compulsory insurance for drivers of motor vehicles. Does the hon. Gentleman accept that the charge has been in place since 1930 and has been discussed and agreed at various times since then?

Dr. Harris: I addressed that point earlier in my speech. No one is suggesting that this is a new charge. This legislation presented an opportunity for the Government not only to re-establish those parts of the charges that they are maintaining but to take the alternative view and move away from charging patients directly. That opportunity has been missed.

Mr. Hutton: Will the hon. Gentleman confirm when his party discovered its opposition to this proposal? As I understand it, the Liberal Democrats have supported these measures previously.

Dr. Harris: My party, like the Labour party, has serious long-standing concerns about those charges. Unlike the Labour party, we demonstrated our concern in our manifesto commitment to freeze prescription charges. The Labour party did not presage in its manifesto the introduction of this legislation which will increase the average cost of car insurance. According to the Association of Community Health Councils for England and Wales and other groups, there was little consultation with patient groups about the Bill. The Government will be on shaky ground if they look to their past record both in and outside this place—particularly regarding indications of intent in party manifestos. I am grateful to the Minister for giving me the opportunity to make that point.
Anyone who is concerned about the regressive nature of the proposals, which re-establish the charges, could maintain that there are better cases than car insurance for making claims on insurance companies and making insurance compulsory. For instance, what about injuries incurred in certain sports to which the less well-off do not have easy access? I refer not to the rugby games enjoyed by the children of the hon. Member for Crawley (Laura Moffatt) but to skiing, for example—which I have had neither the funds nor the courage to try for myself. I do not believe that skiing could be described as a sport that is generally enjoyed across the social classes, yet there are significant costs involved with the treatment of skiing injuries. If one were to argue that the present charge is reasonably fair, one could envisage the

Government's introducing other legislation where my arguments about the regressive nature of the charges apply less.

Mr. Hutton: I am grateful to the hon. Gentleman for giving way again; I appreciate his courtesy. I am sure that he understands that the legislation has nothing to do with self-insurance: it is do with third party compulsory insurance.

Dr. Harris: That is a reassuring comment. I hope that the Minister will confirm that the Government will not move any further towards those sorts of schemes. However, the principle will be breached if the Government seek to raise additional funds for the health service—they make no bones about it; that is what they are doing—by increasing motor insurance when that money could be raised more fairly, transparently and less regressively through general taxation.
There has been debate, some of which I have not followed—particularly the contribution by the hon. Member for West Dorset (Mr. Letwin)—about the nature of compulsory insurance. It has been claimed that because it is compulsory insurance, the charge is okay. That implies that people with optional insurance should not be asked to fund the health service. One can understand the moral pressure that could be brought to bear on people who were asked to contribute voluntarily to the NHS. That could cause philosophical and political problems for the Government.
However, I feel strongly about the way in which the Government have attached national lottery funds to improvements in cancer treatment. One could argue that that is not funding NHS core services—although the Government would have difficulty claiming that improved cancer care is not core to the NHS. The policy is a move away from the position adopted by my party and the Labour party in opposition that lottery funding should not be used to support NHS core services. Cancer is a particularly evocative subject for patients. Because the Government have chosen to fund cancer treatment through that indirect charge—it is the type to which we refer in our reasoned amendment—patients feel that they are somehow doing the NHS the world of good by spending money, which in many cases they do not have, on that form of gambling. Commentators have said that funding the NHS through the national lottery is another example of the rich finding ways to make the poor pay more for the services that everyone uses.

Miss Begg: The hon. Gentleman is straying from the Bill's remit. Surely the Bill's aim is to deal with the anomalies in the existing legislation which I described and to simplify the bureaucracy so that the collection of charges is fairer and easier.

Dr. Harris: I understand the hon. Lady's point and I shall listen carefully for a ruling from you, Mr. Deputy Speaker, rather than from the hon. Lady, if my remarks are not in order. My point is that the principle of co-payment of charges can extend much further than this matter and our objection on Second Reading is based on the fact that if we concede the point and support the Bill, as Government Back Benchers will, we do not know where that extension will end. I know that the Minister has been listening carefully to my remarks, and I seek


clarification on that point. In Committee, I shall take a constructive approach on my specific concerns, which I shall address later.

Mr. Gareth R. Thomas: Should not the hon. Gentleman view the Bill in the same way as the Government's attempt to tackle prescription fraud? The Bill aims to make an existing system work more effectively and fairly and no great new principles are being advocated, as he is suggesting.

Dr. Harris: Liberal Democrat Members are prepared to accept that the Bill will achieve greater efficiency and, by abolishing the emergency treatment charge, more fairness in the existing system. However, the point that I have already made twice—once in response to one of the hon. Gentleman's colleagues—is that by introducing the Bill the Government are re-establishing a principle that can be challenged. They could use this legislative opportunity to say that they will not fund the NHS through flat-rate increases on compulsory insurance. We have a genuine disagreement with the terms of the Bill, and it is valid to oppose it on Second Reading because of the missed opportunity to revoke that principle.
Car parking charges have also been mentioned. One can accept, as I have at my local hospital, the use of car parking charges to encourage people to use public transport and to avoid providing a free parking facility on hospital grounds for people who may have no business to park there. That is a legitimate way to level the playing field and ensure that there is no financial incentive for people to use their cars, particularly in congested areas. That is why the Liberal Democrats support a tax on employers' car parking perks, including those that apply to hon. Members.
When hospital authorities justify high charges by saying that any money raised will go to patient care, they breach the principle that patient care should be funded according to means. I see that the hon. Member for Wakefield is back in his place. He will not have heard me say that I agreed with much of what he said about the principle of sticking to general taxation for raising the bulk of NHS funding. When patient care directly benefits from people paying high car parking charges over and above those needed to control transport congestion, users of the service are being made to pay more than the average taxpayer, which I oppose. After all, on that basis one could argue that there should be a hike in canteen charges over and above what is necessary to break even so that hospitals can make a profit.
Those arguments are of relevance if this legislative opportunity to re-establish a principle is then used to open the floodgates.
It is seen to be an advantage of the Bill that the money to pay for patient care will go directly to hospitals and that the charges have been worked out on a notional basis, such that if all the money was reclaimed it would pay the hospital costs of all road traffic accidents. However, it is worrying that through direct hypothecation, an entire area of the NHS will effectively be paid for by indirect patient charges. Although that may not be the Government's intention, it sets a precedent for future Governments or, perhaps, for this Government in another Session. The costs of road traffic accidents will be paid entirely by co-payment by insurance companies, albeit directly

to hospitals. That is a grave concern, however much the Government assure us that the principle will not be extended.
We must consider the principle mentioned by the hon. Member for South Swindon—I am glad that she made the point for me—who said that it seems illogical to stop at hospital costs. I might support her in Committee if she tables an amendment, because without one, there will be a perverse incentive for hospitals not to discharge patients for community nursing because they will be able to retain the £435 a day that they are able to charge for in-patients.
Another incentive is created by the flat-rate out-patient charge. It may be that it already exists but because hospitals do not collect the charge, it is not at the forefront of administrators' minds. It would be much more cost effective for hospitals to see people once in out-patients, rather than recurrently, because no matter how often people are seen in out-patients, the revenue to the hospital is the same. I question whether purchasers will take note of the Secretary of State's words that the charges are deemed to pay for the entire cost of road traffic accidents and will not be willing to fund such accidents as a part of their contracts with hospitals.
For all those reasons, Liberal Democrat Members cannot support the Second Reading of the Bill. We will work constructively in Committee to improve the Bill, but we seek reassurances from Ministers on the points of principle that I have raised.

Mr. Andrew Dismore: I first took an interest in this subject in the late 1980s, during my work as a solicitor specialising in personal injury litigation. In 20 years of practice as a PI lawyer, I have found it increasingly unfair that, under private health insurance policies, I could be forced by the likes of BUPA to claim back their expenditure on the private treatment of accident victims who were their members, while the NHS could not effectively make similar claims. As a passionate believer in the NHS, I found it particularly galling to send cheques for thousands of pounds to private health insurers, but not to the NHS.
I first flagged up that problem in a pamphlet that I wrote for the Association of Personal Injury Lawyers in 1990. I should say that I have a non-pecuniary interest as a member of APIL's executive committee. I again raised the issue in 1996, in a book published by the Society of Labour Lawyers entitled "Law Reform for All", when I wrote:
Private medical insurers such as BUPA are entitled to recover their outlays, and the NHS should not be put in a more disadvantageous position than a medical insurer.
Of course, as hon. Members have said, there is nothing new in what the Bill proposes. Recovery of medical expenses was first introduced in Herbert Morrison's Road Traffic Act 1930, which also introduced compulsory insurance for motor vehicles.
Equally, there is nothing new about the tort principles of common law, which have provided restitutory rights going back centuries. In its response to the Law Commission in April 1997, APIL said:
We believe that not to provide a right of recoupment would grant the tortfeasor an unjust benefit, paid by the taxpayer, in that the taxpayer is righting the wrong committed by the tortfeasor through the payment for the treatment of the victim.


What is new is that people have been waking up to the unfairness of the system for the NHS, and, more importantly, its patients. In Personal Injury magazine in 1996, the general editor, Frederick Holding, said:
the medical and legal communities should wake up to the fact that the insurance industry is having a parasitic effect on the taxpayer, the welfare state and NHS emergency services in particular. It is little wonder that the NHS is in crisis when victims of serious accidents, who have the legal right to have their treatment paid for by the insurers of the tortfeasor, are still draining the resources of an NHS system".
That, of course, was the position under the previous Government, and there have been great improvements in the health service since then, but the basic principle still applies.
I was pleased that the Law Commission took an interest in the subject in its full and well-argued consultation paper No. 144, which was published in December 1996 and in which it flagged up the issues involved. My only regret at the time was the Tory Government's complete failure to take on board the possibilities raised by the Law Commission. I am extremely pleased that my right hon. Friends the Secretary of State and the Chancellor have reacted so quickly by introducing this Bill.
This is not a tax on accidents, as the Tories have claimed. The Bill allows the NHS to get back what it is rightly owed. A great deal of debate has focused on motorists, but half the road accident victims are pedestrians, cyclists and passengers, and are not responsible for insurance; they just need to be treated.
The hon. Member for Poole (Mr. Syms) mentioned uninsured drivers. There is a general problem in people failing to take out insurance, and the amount involved in this Bill is a fleabite compared to the total bill of the Motor Insurers Bureau. One way forward could be through the introduction of insurance discs for motor vehicles in a similar way to tax discs, so that we can catch those without insurance.
Despite the provisions of the Road Traffic Act 1930 and the various amendments now consolidated in the Road Traffic Act 1988, the insurance industry has been getting away with ripping off the NHS for years. Of course, the NHS did not pursue its rights effectively, and has let the insurance industry off the hook. However, the fact remains that insurers have not been paying out what they should. They have made windfall profits at the expense of NHS patients for decades.
We are told that premiums may have to go up. The best estimate so far is that they may go up by £6 to £9. I believe that the competitive market for insurers could well absorb that expenditure. That figure overlooks a number of key advantages introduced by this scheme. First, there are advantages for road safety. Car insurance is worked out according to risk, and bad drivers pay more. If part of the impact of the scheme is that bad drivers have to pay more for their insurance, they may improve their driving standards. One third of a million people are injured on our roads each year, and we need to look at the advantages for road safety.
A further advantage is the care of the victims. In the personal injury world, there is a new and growing concern for the victim's wider interests, going beyond compensation alone. Increasingly, we are seeing moves to

look much more at issues such as the need for rehabilitation care, intensive physiotherapy and so on, so that we can do all that can be done to improve a victim's recovery. Regrettably, such services are somewhat patchily available in the NHS, and some places are better than others.
There are discussions in principle and on individual cases between those who represent victims and the insurers, trying to persuade the insurers that it is in their interests as well as those of the victims to fund such care packages. In the long run, it is cheaper to compensate a fully or better recovered victim than someone with on-going disabilities. If the on-going cost of NHS treatment is to be met by insurers, it will be a real incentive for them to look to the better and quicker recovery of the injured person
In APIL' s submission to the Law Commission, we said:
We believe that recoupment will encourage insurers to adopt a broader approach to the plaintiff's condition beyond mere damages. Insurers will be encouraged to organise private care regimes at an earlier stage, where the extent and cost of the care regime can be negotiated and agreed between the parties, to their mutual benefit.
That could also relieve some pressure on NHS services.
The measure will also generate additional funds for the NHS, as the money recovered will be ploughed back into the hospitals concerned, allowing more patients to be treated more quickly.
According to the reply that I received to a parliamentary question last year, currently only £13 million comes back to the NHS. The Wellhouse Trust, which is the acute service provider in my area, clawed back only £45,000 in 1996–97, despite treating almost 89,000 patients in the accident and emergency department, let alone any follow-up in-patient care or elective surgery that might have been needed. That works out at just 50p per casualty. Of course not all those patients were road accident victims, but that shows the scale of the problem.
In 1990, the total cost to the NHS of all accidents was estimated at £1 billion. According to a 1984 study, road accidents account for 18.5 per cent. of all accidents, and result in 34 per cent. of victims bringing claims. Allowing for a proportion of those not succeeding, the estimate of about £50 million or £60 million seems fairly accurate—four times what is currently being recovered, but significantly less than some of the scare stories being put around by some in the insurance industry. I wish that it was higher, but we have to be realistic.
I hope that we will look at a substantial capping of the ceiling. A total of £10,000 is all well and good, but I recall in the past having to send cheques to BUPA for tens of thousands of pounds in response to its incredibly itemised bills. The NHS should be on the same level playing field. I believe that a tariff-based approach is correct, but as we get into better benchmarking of NHS treatment costs, I hope that we can produce a more sophisticated tariff based on the benchmark costs of various procedures. That would result in rewarding efficient hospitals, and encouraging the less efficient to improve towards the average.
I do not believe that the Bill deals well with the length of the recoupment period. The Department of Social Security has a sensible rule, limiting recovery to the date of settlement or five years from the accident. That provides an added incentive to insurers to deal with claims promptly, which I am sure we all wish to see.
I believe that the Government are correct to put the administration of the scheme into the hands of the compensation recovery unit. When that was first set up by the Tories in 1989 for DSS recoupment, it was a real disaster. It worked unfairly against the interests of victims, and led to many calls for its reform, not least from the Association of Personal Injury Lawyers, the Trades Union Congress, the Law Society and others, and ultimately the Select Committee on Social Security.
Having done some work on this, I found myself in the rather peculiar position of advising the then Tory Government, Labour Front Benchers and Liberal Democrat Front Benchers at the same time on reforms to the legislation. That emerged as the Social Security (Recovery of Benefits) Act 1997, which dealt with many of the problems we were experiencing. The CRU is now a major success story.
The hon. Member for Uxbridge (Mr. Randall) mentioned the cost of the CRU. I took that up at the time, and was told that the unit cost of a recoupment claim for the DSS was less than £10. The system that we are introducing with this Bill will be cheaper, because it is simpler. In response to the question raised by the hon. Member for West Dorset (Mr. Letwin), the CRU recovers £180 million a year, one third of which is from road accidents. It has done so efficiently, and by respecting the necessary confidences of all parties involved.
My right hon. Friend the Secretary of State is right to ensure that victims are excluded from the operation of the scheme. That problem was always one of the failings of the DSS scheme, and it remains a problem, although it is dealt with in a much better way now. By keeping the victims out, we reinforce the message that there is no question of the victim having to pay for medical treatment. That must remain free at the point of delivery.
However, in that way, we can also enlist the help of victims in recovering what is due to the NHS. If victims are given copies of the certificates, they can say whether they are accurate or whether there is an under-estimate. Victims are much more likely to co-operate with the Department's CRU than with some of the private companies that have sprung up. I am sure that the Government have had many approaches from such companies saying that they could do a better job. Compared to the present system, that is undoubtedly so, but we should resist their blandishments, because the CRU will knock spots off them when the new scheme is set up.
The confidentiality of the CRU will help to reduce the growing abuse of claims assessors, putting pressure on victims to bring claims via their dubious services. That often results in victims recovering less compensation overall at a higher price to them through the contingency fee arrangement. Many of the companies involved in road traffic accident recoupment so far on behalf of trusts have a "claims assessor" arm. I believe that there is some evidence that they have abused the information given them by the trusts to drum up trade, putting pressure on victims. Victims must be properly informed of their rights, but they must not be pressured into bringing claims that they would not otherwise bring.
If I have one concern about the Bill, it is that perhaps it does not go far enough. I hope that, when the Law Commission report is published, it will be carefully considered by the Government. I believe that that report

is promised for February 1999. It is proper for us to await the outcome of that report before looking further at these proposals, but there are some extensions that we should look at.
First, there is the NHS drugs bill. For donkey's years, accident victims have recovered the amount they spend on prescription charges and proprietary medicines. Of course, the total cost to the NHS of the medicines involved is far greater, and we should look to the insurers for the difference between the amount paid by the patient and the cost to the NHS. That may be an administrative problem at the moment, but, with better computerisation, it can be overcome. For example, I once recovered over £500 in prescription charges for a victim. Just think what the total cost to the NHS must have been for the medication received by that victim. The topping up to the full cost requires further examination.
Secondly, we have heard a great deal in the debate about how the scheme could be extended to other areas. I believe that we should look at other areas of compulsory insurance, particularly accidents at work and employers' liability. Such accidents account for half as many injuries again as road accidents—27 per cent. compared with 18.5 per cent of all personal injury accidents. With the help of trade unions' well-developed legal assistance schemes, 24 per cent. of victims claim. Such an extension of the scheme would probably double the amount recoverable.
I can see no philosophical difference between those two areas of compulsory insurance, and believe that both could be made subject to NHS recoupment. In fact, there are positive advantages. In the same way as these proposals could impact on road safety and better care of road accident victims, they could have an impact on health and safety in the workplace, by strengthening the drive for better working conditions through insurers being tougher with bad and unsafe employers, and through better rehabilitation, helping injured employees to get back to work more quickly.
My third suggestion concerns the cost of long-term care, which is sometimes borne by the NHS but more often by local authorities. The legal position on recoupment of these costs is very unclear. Some local authorities expect accident victims or their representatives to sign subrogation agreements, and either expect the victims' lawyers to get the moneys from the insurer, or, even worse, try to claw it back after the event from victims' compensation.
This uncertain area of the law means that disputes are often long drawn out, making cases harder to settle. Sometimes it results in satellite litigation, such as the case of Avon v. Hooper in December 1997, in which Avon county council tried to get the money out of the deceased victim's family, adding to that family's distress. It would be far better if the legal position were clarified through legislation such as this. I should certainly like to see local authorities in a similar position to the NHS in being able to recover their costs.
I very much welcome the Bill, which is long overdue. It will bring in additional and badly-needed resources to the NHS. It will ensure that those responsible for road accidents meet the full costs, through their insurers, of their negligence. I hope that we shall continue this reform process along the lines that I have described.

Mr. Gareth R. Thomas: I shall speak briefly to support the Bill, and perhaps I can set it in its proper context, as only one small part of a package of measures that will modernise our approach to health. That package clearly includes the £21 billion of extra investment from the comprehensive spending review. It also includes various measures to tackle prescription fraud. It ranges from the reforms of the national health service modernisation Bill to many of our public health measures, such as extra investment in housing and modernisation of local government, through to the Government's work to tackle financial exclusion.
The Bill is not about the introduction of a tax on motorists, and there are no great new issues of principle involved. I remember being in the Chamber when the hon. Member for Rutland and Melton (Mr. Duncan) promised us mature and constructive opposition. The shadow Secretary of State, the right hon. Member for Maidstone and The Weald (Miss Widdecombe), was never so ambitious. I assume that that is why the hon. Member for West Dorset (Mr. Letwin) was allowed to run with the scare story that compulsory health insurance would somehow result from the Bill.
For more than 60 years, hospitals have had the right to recover some of the costs of treating victims of road accidents. Indeed, since the introduction, under the Conservative Government, of the Road Traffic Act 1988, those costs are in theory recoverable from an insurance company. I say that that is the position "in theory", because the system, mirroring the wider Conservative approach to health care in the late 1980s and early 1990s, was highly bureaucratic and overly complex, and created unnecessary administrative burdens. The Bill will simplify and improve the way in which money is collected, so that the NHS gets the money to which it has been entitled for the past 50 years.
The hon. Member for Uxbridge (Mr. Randall) did the debate a service when he highlighted the wide variations in moneys that have been collected by hospitals. That variation is clearly because of the complex bureaucracy that has been so lucidly outlined by my hon. Friend the Member for Hendon (Mr. Dismore) and others. My hon. Friend the Member for Wakefield (Mr. Hinchliffe), in highlighting many of the health charges facilitated by the health reforms introduced by the previous Conservative Government, performed a useful service in signalling the double standards that lie behind the Opposition's amendment.
In contrast to the scare stories of the Liberal Democrats, the Bill will abolish a charge on patient care. It will move the NHS even closer to its founding principle of a service available when needed, where it is needed, with clinical need, not income, the key determinant.
The Bill will abolish the emergency treatment fee which has to be collected by NHS staff from injured motorists. As my hon. Friend the Member for South Swindon (Ms Drown) said, that process causes offence and embarrassment. It is a completely unwelcome distraction from what NHS staff do so well, which is looking after the injured.

Dr. Harris: Does the hon. Gentleman feel that the proposal returns the NHS to a mainly taxation-funded system, even if the increased efficiencies of the scheme

increase the proportion of NHS revenue that is raised from such charges? Does that return the NHS more to the principles of taxation?

Mr. Thomas: In the sense that the purpose of the Bill is to abolish one of the charges on patient care, it will clearly return to the founding principles that I have outlined.
The emergency treatment fee is highly unfair. It is levied regardless of whether the injured person was responsible for the accident. It is clear that the NHS has not been receiving the moneys to which it has been entitled. We know that only £13.17 million was recouped for the NHS in 1995–96 under existing legislation. According to recent estimates, NHS trusts could have claimed £50 million, £100 million, or—much less likely—anything up to £440 million.
The first beneficiaries of the reforms in the Bill will be the Opposition parties, whose difficulties on health service financing are well documented. It will not solve those difficulties for them, but it will provide some small fig leaves to small parts of the holes in their funding plans. The right hon. Member for Maidstone and The Weald cannot obtain permission from the shadow Chancellor of the Exchequer to welcome the £21 billion of new investment in the NHS, or to offer positive suggestions on how that money should be spent. Apart from some vacuous waffle about more private sector investment, the shadow health team has not suggested where the money will come from for more investment in the health service.
The Liberal Democrats, too, will benefit. They threw out the plans of the hon. Member for Southwark, North and Bermondsey (Mr. Hughes) at their conference, without one vote in favour. Indeed, the party's plans were described as shambolic. It is therefore not surprising that both the Conservatives and the Liberal Democrats have rushed to exaggerate, quoting the highest estimates they can find of the likely income that the Bill will generate.
As the Liberal Democrat approach to finances owes more to Heath Robinson than to accounting guidance, I am certain that, just as with their 1p on income tax, the modest moneys raised through the Bill will be spent many times over in the coming months.
Even £100 million extra would make an important difference to the services that hospitals can supply. Such a sum will provide small additional increases in income over and above the £21 billion that will be invested throughout the health service. That investment was described by the NHS Federation as beyond its wildest dreams. It was described by the Institute of Health Service Management as a
massive injection of new cash.
The truth, sadly, is that, such has been the scale of under-investment in patient care by the Conservative party, it would be entirely irresponsible to fail to secure these extra funds, to which hospitals have always been entitled, for the treatment of road traffic accidents.
The Bill is an entirely sensible measure, which is long overdue. It will help to modernise the way in which we collect moneys due to the health service, and I warmly welcome it.

Mr. Alan Duncan: We have had a lively and wide-ranging debate. Indeed, it has perhaps been rather more lively than some right hon. and hon. Members expected when they entered the Chamber this afternoon.
Perhaps the Bill and the Road Traffic Act 1988, which goes in harness with it, can best be described as measures that allow the national health service to piggy-back successful claims for compensation so as to recoup some of the health treatment costs from insurance companies. As every Opposition Member has said, including my right hon. Friend the Member for Maidstone and The Weald (Miss Widdecombe)—I am happy to reiterate this—we do not challenge that principle. However, we challenge the Government to explain how what they are doing by means of the Bill fits into any policy that they have previously expressed on charging in the NHS. We challenge them also to justify increasing the incidence and burden of costs on motorists, who are already very hard pressed.
The House will have noticed that what the Government are doing was never in the Labour party's manifesto. Labour did not give a clue to the electorate, whose vote they sought, that it would do something like this. It is yet another typical example of Labour saying one thing and doing another.
The Bill comes at a cost to the motorist in the form of a compulsory charge. We have tabled our reasoned, and reasonable, amendment to highlight that cost, and I welcome the Liberal Democrats' decision to join us today in the Lobby.
I listened very carefully to the Secretary of State's speech. He brazenly said that the proposals in the Bill will not cause the imposition of any new charges. Technically, in some respects, he is right. However, the magnitude—[Interruption.] As I told the House and Labour Members, I am nothing in debating these matters if not reasonable and constructive. I should think that even Labour Members will appreciate that the charge's magnitude and incidence will be dramatically increased. The charge will therefore be bigger and more burdensome.
Opposition Members agree with the Government on the proposal to abolish the emergency treatment fee. I do not quite understand why—perhaps the Minister will explain it to the House—general practitioners and hospitals can still collect that fee. I look forward to hearing the Minister's explanation of why they can do so.
The hon. Member for Carlisle (Mr. Martlew) is a very confused man. He said that the case of the German tourists who incurred a £45,000 bill in his constituency was a simple one because the insurance company paid the bill, although he was unable to explain to us the difference between insurance charges—which he was advocating and said were acceptable—and general health insurance. His exact words were that his constituents would feel that insurance charges were "a charge worth paying to support the health service." In a subsequent intervention, he supported charges in principle and criticised proposals to abolish them. Thus, he became the first Labour Back Bencher to support insurance premiums for national health service treatment.
The hon. Member for Southwark, North and Bermondsey (Mr. Hughes) was quite right that the Bill would increase the scale of the current scheme. He also argued that a premiums increase would be a regressive

tax. He was quite right also to say that the Government think of charges as an easy little pot of resources on which to draw.
The hon. Member for Wakefield (Mr. Hinchliffe) mentioned the Law Commission, and said that it might well recommend extending the scope of the type of scheme proposed in the Bill. He appeared to endorse such an extension. He said that he does not want health insurance. However, in one respect, he will have it—and he is supporting it—in the Bill.

Mr. Hinchliffe: If the hon. Gentleman reads my speech tomorrow, he will see that I did not say that. I specifically distanced myself from proposals to extend the scheme, as he is suggesting. Will he deal with the point that I made on the inconsistency between the reasoned amendment tabled by the shadow Health Secretary and her colleagues and the previous Government's introduction of car-parking charges?

Mr. Duncan: The inconsistency today is among Labour Members—some of whom want to extend the scope of the scheme, some of whom want to reduce it and some of whom want to keep it as it is. They are totally at odds one with another.
My hon. Friend the Member for Uxbridge (Mr. Randall) rightly pointed out the effect on motorists of charging.
The hon. Member for Aberdeen, South (Miss Begg) vividly described the crash that she herself suffered. So well did she describe it that, for a moment, I almost felt that I was in that car. However, she was yet another Labour Member welcoming NHS charges as proposed in the Bill.
My hon. Friend the Member for Poole (Mr. Syms) made it clear that a charge is a charge. He spoke of the effect of uninsured motorists, and drove a coach and horses through any remaining pretence that the Government have any consistent principle in their thinking.
The hon. Member for Crawley (Laura Moffatt) seemed to give full support for national health service health insurance, and admitted that it would be a compulsory charge for NHS treatment.
My hon. Friend the Member for West Dorset (Mr. Letwin)—who has apologised to you, Mr. Deputy Speaker, and to the House for not being able to stay for the conclusion of the debate—ably described how the Government are so devoid of principle that, in the Bill, they are doing the opposite of what they led the electorate to expect before the general election. Although I was very grateful for his kind words about my libertarian credentials, I was more grateful to him for cogently dissecting what I and everyone else now recognise as the Government's intellectual poverty.
The hon. Member for South Swindon (Ms Drown) is a public sector accountant. Therefore she, above all, should know about compulsory insurance. However, she made no case as to why only motorists should face paying such a charge.
The hon. Member for Oxford, West and Abingdon (Dr. Hams) made yet another plea for some expression of principle by the Government. I fear that his plea will have fallen on deaf ears.
The hon. Member for Hendon (Mr. Dismore) clearly is new Labour. He tried to give credit for the Bill to the grandfather of the Secretary of State for Trade and Industry. If the hon. Gentleman drives as fast as he speaks, he will always be done for speeding. He wishes to extend the charging concept, whereas the hon. Member for Wakefield—who is sitting behind him—does not.
The hon. Member for Harrow, West (Mr. Thomas), too, seems to be totally at odds with the hon. Member for Wakefield.
The Government's approach to the Bill demonstrates their incoherence on the overall issue of national health service charging and on the way in which money in the health service works. The Secretary of State keeps saying that there is no rationing; yet the Government—as they always have done—ration. He said that NHS charges must never exist; yet—in this very Bill—the Government most clearly will charge. The Bill will broaden the incidence of charging. The Secretary of State rails against charges, but today he promotes them. It is an extraordinary volte-face.
The Bill will increase the scope of charging for treatment, but where is its logic? What will happen next? Let us consider an example that is currently in the news. Barry Horne, an animal rights activist, is on hunger strike. No one has injured him; he is inflicting his condition on himself. He is in a hospital in Yorkshire and is a cost to the national health service. Does the Secretary of State think that he should be charged in some way for the treatment that he is receiving? Does he think that he should pay the costs of the delayed opening of the hospital's new cancer ward, if it is delayed?
Does the Secretary of State think that charging will eventually be applied to other places that are insured, such as offices and homes, where there might be a fire or an accident? Will charging be applied to train crashes or to dreadful, massive events such as Hillsborough or Zeebrugge when compensation is paid out?
Does the Secretary of State intend—perhaps he will do the House the courtesy of listening—that, one day, charging might extend to what is deemed a "class action" against tobacco manufacturers, so that those smokers—whose treatment clearly has imposed a cost on the NHS—also have to pay?
The logic of the legislation shows that it is not about risks that are compulsorily insured but about cases in which compensation happens to be delivered and in which, in the case of motorists, there happens to be compulsory insurance. It is an easy route to a wider charge. No proof of fault is required. There was no principle in the Secretary of State's statement about insurance being compulsory. The simple fact is that compensation in such cases can easily be traced and then returned to the national health service.
The costs of charging will be passed on. Estimates of the costs range from £50 million to £450 million. Even if the costs figure falls between the high and low estimates, they will cause motorists a notable expense.
Let us be clear about it: the Government's proposals will hereby extend compulsory charging for NHS treatment of motorists. Let us ignore the Secretary of State's words; let us look at his deeds.
Motorists will be hit—perhaps, if the higher estimate applies, quite hard. Motorists have already had to pay £9 billion extra in fuel tax. After today's announcement

by the Deputy Prime Minister, they will probably have to pay road charges. Their vehicle excise duty has gone up, and they face a new car registration tax. Now, they will have to pay for the Bill's proposals.
I think that the Secretary of State probably used to attack the insurance premium tax, but now he is introducing another tax. He even had the gall to say that insurance premiums will not rise, and cited the case of Direct Line insurance, which essentially said that it already factored in the charges. A charge on an institution does not mean that the individual is not eventually charged. The Government are proposing a wider and more burdensome charge that will fall on the hard-pressed motorist. I urge the House to support our reasoned amendment.

The Parliamentary Under-Secretary of State for Health (Mr. John Hutton): As the hon. Member for Rutland and Melton (Mr. Duncan) said, this has been a lively debate. More importantly, it has been a well informed and useful debate, in which several hon. Members, particularly Labour Members, have brought their professional and personal experiences to bear on the issue. I should like to respond as fully as possible to the points that have been raised. If I am not able to cover all the points, I shall write to the relevant hon. Members when I have an opportunity for more detailed consideration.
I am afraid that the speech by the hon. Member for Rutland and Melton has come roughly 70 years too late. The subject matter of the Bill has been on the statute book for that long. As I am sure that he would be the first to admit, when the Conservatives had the opportunity to consider the issue, they endorsed the principle that we are debating.
We have heard sensible contributions from my hon. Friends the Members for Carlisle (Mr. Martlew), for Wakefield (Mr. Hinchliffe), for Aberdeen, South (Miss Begg), for Crawley (Laura Moffatt), for South Swindon (Ms Drown), for Hendon (Mr. Dismore) and for Harrow, West (Mr. Thomas). I shall also deal with some of the points made by Opposition Members.
My hon. Friend the Member for Carlisle welcomed the abolition of the emergency treatment fee, as did many other hon. Members. It will be widely welcomed, particularly in the national health service. He highlighted the inefficiencies of the present scheme and mentioned the benefits that the new arrangements will bring to the national health service in Cumbria.
The hon. Member for Southwark, North and Bermondsey (Mr. Hughes) appeared to be in favour of statutory mechanisms for setting the price of motor insurance, which I found curious. He proceeded to read out most of the Liberal Democrat reasoned amendment, which did not add much to our proceedings. He then tried manfully to distinguish it from the Conservative reasoned amendment, which he went on to say that he would vote for anyway. That is the Liberal Democrats.

Mr. Simon Hughes: Oh dear! We had hoped better of the new Minister, but he has yet to amend his ways. He


has mentioned insurance contributions. Can he guarantee that insurance premiums for car drivers will not go up as a result of the Bill?

Mr. Hutton: I intend to deal with that later in my speech.
My hon. Friend the Member for Wakefield also welcomed the abolition of the emergency treatment fee and pointed out the inconsistencies in the Opposition position. He did us all a favour by drawing attention to the ambiguous position adopted by the Conservatives.
My hon. Friend the Member for South Swindon referred to her experience of trying to administer the existing arrangements. She spoke for many in the national health service when she welcomed the proposals. She described the existing arrangements as complicated and bureaucratic. I assure her that we want the new arrangements to be clear and straightforward. Local hospitals should benefit directly.
My hon. Friend the Member for Aberdeen, South made a persuasive and effective speech, drawing attention to the absurdities of the present arrangements and the fact that the national health service loses out. I welcome her support for the Bill. She also pointed out that the new arrangements will apply to the national health service in Scotland.
The hon. Member for Poole (Mr. Syms) repeated his concerns about the impact on motorists. I shall deal with that in a moment. He also expressed concerns about what he described as new bureaucracy in the arrangements. That is rich coming from the Conservatives. We are proposing a streamlined system for recovering the charges that are owed to the national health service. It is the best and least bureaucratic scheme that we can devise and it will deliver benefits to the national health service. Intriguingly, he said that he supported some parts of the Bill, but declined to say which. It is a shame that he is going to join his hon. Friends in voting against the Bill.
My hon. Friend the Member for Crawley welcomed the involvement of the compensation recovery unit. She brought her experience as a nurse to the debate on the emergency treatment fee. She rightly said that the Bill is about fairness.
I am sorry that the hon. Member for West Dorset (Mr. Letwin) is not in his place. Of course, that gives me an opportunity not to refer to his speech, which is a serious temptation. However, I should let my right hon. Friend the Secretary of State know that the hon. Gentleman expressed his admiration for him, which was gratefully received by Labour Members. Unfortunately, the hon. Gentleman spoiled it by failing to understand the terms of the Bill or the Government's policy. That revealed the confusion that underpins the Conservative response to our proposals. Sadly, he allowed the hatred of everything European to surface again. He deserves some praise for his ingenuity in getting Europe into the debate. Like other Opposition Members, he has sought to read more into the Bill than he should.
The hon. Member for Oxford, West and Abingdon (Dr. Harris) joined the hon. Member for Southwark, North and Bermondsey in showing that the Liberal Democrats do not have a coherent or rational position on this occasion—as on many other occasions. It is a mistake for them to join the Conservatives in opposing the Bill.

Mr. Simon Hughes: The Minister cannot seriously say that the Government's position is coherent. They say that

they are against more charges, but they are bringing forward a Bill that would allow charges in one area to go up. No charges were mentioned in the Labour manifesto, but suddenly, hey presto, the Government are to produce more money from somewhere and charge the public for it.

Mr. Hutton: The hon. Gentleman has not understood the Bill. No new charges are being introduced. I thought that he had tried to make that point. The logic of his argument, although he did not spell it out in detail, is that he wants to increase taxes substantially. He will have to deal with that when the voters make their judgment at the next general election.
I should like to return briefly to the subject of the debate—the Bill. As my right hon. Friend the Secretary of State pointed out, it will enable hospitals to benefit fully for the first time in more than 60 years from the provisions that successive Administrations have endorsed, although they have never been given practical effect. This is not the first step on a slippery slope towards charging for NHS treatment. Let me make it crystal clear—no patient is to be charged and no one will be required to insure themselves against the cost of future treatment. The principle that has been in force throughout the existence of the NHS remains: the road user is required to insure against risk to third parties. That includes reimbursing hospitals for the cost of treating third parties.
We are not talking about charging everyone involved in a road accident for the cost of NHS treatment. The charges will be levied only when a claim for compensation arising from a road traffic accident has been made. The charge will be levied against the insurer of the person responsible for the accident. We estimate that approximately 40 per cent. of all road traffic accidents will be covered by the Bill.
Reference has been made to insurance premiums. Much of what has been said and written is patently untrue. Our figures show that if insurers pass on the charge—which is by no means certain, as some insurers have been open enough to admit—the effect on the average premium should be very small indeed—around 2 to 3 per cent. or £6 to £9. Insurers already factor potential NHS charges—whether or not they are collected—into premiums.
As many of my hon. Friends have said, our new system will see in NHS hospitals the end of the iniquitous charging of the emergency treatment fee. That will be better for drivers, hospitals and insurers. Each year there are hundreds of thousands of small transactions between hospitals and drivers and drivers and their insurance companies which will end when the Bill receives Royal Assent. At the current rate of £21.30, the cost of that process must certainly outweigh the benefit. The abolition of the emergency treatment fee will be welcome news to many people in and outside the national health service.
NHS care is and will remain free to all those who need it. The Bill does not affect that principle. It does not usher in a free season on that principle and it does not remotely hint at a change in direction. Nobody will be denied care or be prevented from seeking it as a result of the Bill. NHS patients stand to benefit directly from the practical steps brought in as a result of the measure and on that basis I commend it to the House.

Question put, That the amendment be made:—

The House divided: Ayes 150, Noes 347.

Division No. 18]
[7.41 pm


AYES


Ainsworth, Peter (E Surrey)
Jenkin, Bernard


Allan, Richard
Keetch, Paul


Arbuthnot, Rt Hon James
Key, Robert


Atkinson, Peter (Hexham)
Kirkbride, Miss Julie


Baker, Norman
Kirkwood, Archy


Ballard, Jackie
Laing, Mrs Eleanor


Body, Sir Richard
Lait, Mrs Jacqui


Bottomley, Peter (Worthing W)
Lansley, Andrew


Brady, Graham
Leigh, Edward


Brake, Tom
Lewis, Dr Julian (New Forest E)


Brand, Dr Peter
Lidington, David


Brazier, Julian
Lilley, Rt Hon Peter


Breed, Colin
Lloyd, Rt Hon Sir Peter (Fareham)


Browning, Mrs Angela
Loughton, Tim


Bruce, Ian (S Dorset)
Luff, Peter


Bruce, Malcolm (Gordon)
Lyell, Rt Hon Sir Nicholas


Burns, Simon
MacGregor, Rt Hon John


Butterfill, John
Maclennan, Rt Hon Robert


Campbell, Menzies (NE Fife)
McLoughlin, Patrick


Chapman, Sir Sydney (Chipping Barnet)
Malins, Humfrey



Maude, Rt Hon Francis


Chidgey, David
Mawhinney, Rt Hon Sir Brian


Chope, Christopher
May, Mrs Theresa


Clappison, James
Michie, Mrs Ray (Argyll & Bute)


Clark, Rt Hon Alan (Kensington)
Moore, Michael


Clark, Dr Michael (Rayleigh)
Morgan, Alasdair (Galloway)


Clarke, Rt Hon Kenneth (Rushcliffe)
Moss, Malcolm



Norman, Archie


Clifton-Brown, Geoffrey
Oaten, Mark


Colvin, Michael
Öpik, Lembit


Cotter, Brian
Ottaway, Richard


Cran, James
Page, Richard


Day, Stephen
Paterson, Owen


Duncan, Alan
Pickles, Eric


Emery, Rt Hon Sir Peter
Prior, David


Evans, Nigel
Randall, John


Ewing, Mrs Margaret
Redwood, Rt Hon John


Faber, David
Rendel, David


Fabricant, Michael
Robathan, Andrew


Fallon, Michael
Robertson, Laurence (Tewk'b'ry)


Foster, Don (Bath)
Roe, Mrs Marion (Broxbourne)


Fox, Dr Liam
Rowe, Andrew (Faversham)


Gale, Roger
Ruffley, David


Garnier, Edward
Russell, Bob (Colchester)


George, Andrew (St Ives)
St Aubyn, Nick


Gibb, Nick
Sanders, Adrian


Gill, Christopher
Sayeed, Jonathan


Gillan, Mrs Cheryl
Shephard, Rt Hon Mrs Gillian


Gorman, Mrs Teresa
Simpson, Keith (Mid-Norfolk)


Gorrie, Donald
Smith, Sir Robert (W Ab'd'ns)


Gray, James
Spicer, Sir Michael


Green, Damian
Spring, Richard


Greenway, John
Stanley, Rt Hon Sir John


Grieve, Dominic
Steen, Anthony


Gummer, Rt Hon John
Stunell, Andrew


Hammond, Philip
Swayne, Desmond


Harris, Dr Evan
Swinney, John


Harvey, Nick
Syms, Robert


Hawkins, Nick
Taylor, John M (Solihull)


Hayes, John
Taylor, Matthew (Truro)


Heath, David (Somerton & Frome)
Tonge, Dr Jenny


Hogg, Rt Hon Douglas
Townend, John


Horam, John
Tredinnick, David


Howard, Rt Hon Michael
Trend, Michael


Howarth, Gerald (Aldershot)
Tyler, Paul


Hughes, Simon (Southwark N)
Tyrie, Andrew


Hunter, Andrew
Viggers, Peter


Jack, Rt Hon Michael
Wallace, James


Jackson, Robert (Wantage)
Walter, Robert





Wardle, Charles
Wilshire, David


Waterson, Nigel
Winterton, Mrs Ann (Congleton)


Webb, Steve
Winterton, Nicholas (Macclesfield)


Wells, Bowen
Woodward, Shaun


Whitney, Sir Raymond
Young, Rt Hon Sir George


Whittingdale, John



Widdecombe, Rt Hon Miss Ann
Tellers for the Ayes:


Willetts, David
Sir David Madel and


Willis, Phil
Mr. Tim Collins.




NOES


Abbott, Ms Diane
Colman, Tony


Adams, Mrs Irene (Paisley N)
Connarty, Michael


Ainger, Nick
Cook, Frank (Stockton N)


Ainsworth, Robert (Cov'try NE)
Cooper, Yvette


Alexander, Douglas
Corbett, Robin


Allen, Graham
Corston, Ms Jean


Anderson, Donald (Swansea E)
Cousins, Jim


Anderson, Janet (Rossendale)
Cranston, Ross


Armstrong, Ms Hilary
Crausby, David


Ashton, Joe
Cryer, Mrs Ann (Keighley)


Atherton, Ms Candy
Cryer, John (Hornchurch)


Atkins, Charlotte
Cummings, John


Austin, John
Cunliffe, Lawrence


Barnes, Harry
Cunningham, Rt Hon Dr Jack (Copeland)


Barron, Kevin



Battle, John
Cunningham, Jim (Cov'try S)


Bayley, Hugh
Curtis-Thomas, Mrs Claire


Beckett, Rt Hon Mrs Margaret
Dafis, Cynog


Begg, Miss Anne
Dalyell, Tam


Benn, Rt Hon Tony
Davey, Valerie (Bristol W)


Bennett, Andrew F
Davidson, Ian


Bermingham, Gerald
Davies, Rt Hon Denzil (Llanelli)


Berry, Roger
Davies, Geraint (Croydon C)


Betts, Clive
Davis, Terry (B'ham Hodge H)


Blackman, Liz
Dawson, Hilton


Blears, Ms Hazel
Dean, Mrs Janet


Blizzard, Bob
Denham, John


Blunkett, Rt Hon David
Dismore, Andrew


Boateng, Paul
Dobbin, Jim


Borrow, David
Dobson, Rt Hon Frank


Bradley, Keith (Withington)
Donohoe, Brian H


Bradley, Peter (The Wrekin)
Doran, Frank


Bradshaw, Ben
Dowd, Jim


Brinton, Mrs Helen
Drew, David


Brown, Russell (Dumfries)
Drown, Ms Julia


Browne, Desmond
Dunwoody, Mrs Gwyneth


Buck, Ms Karen
Eagle, Angela (Wallasey)


Burden, Richard
Ellman, Mrs Louise


Burgon, Colin
Ennis, Jeff


Butler, Mrs Christine
Etherington, Bill


Byers, Rt Hon Stephen
Field, Rt Hon Frank


Caborn, Richard
Fisher, Mark


Campbell, Mrs Anne (C'bridge)
Fitzpatrick, Jim


Campbell, Ronnie (Blyth V)
Flint, Caroline


Campbell—Savours, Dale
Flynn, Paul


Canavan, Dennis
Follett, Barbara


Cann, Jamie
Foster, Rt Hon Derek


Caplin, Ivor
Foster, Michael Jabez (Hastings)


Casale, Roger
Foster, Michael J (Worcester)


Chapman, Ben (Wirral S)
Foulkes, George


Chaytor, David
Fyfe, Maria


Chisholm, Malcolm
Galbraith, Sam


Clark, Rt Hon Dr David (S Shields)
Gapes, Mike


Clark, Dr Lynda (Edinburgh Pentlands)
Gardiner, Barry



Gerrard, Neil


Clark, Paul (Gillingham)
Gibson, Dr Ian


Clarke, Eric (Midlothian)
Gilroy, Mrs Linda


Clarke, Rt Hon Tom (Coatbridge)
Godman, Dr Norman A


Clarke, Tony (Northampton S)
Godsiff, Roger


Clelland, David
Goggins, Paul


Clwyd, Ann
Gordon, Mrs Eileen


Coaker, Vernon
Griffiths, Jane (Reading E)


Coffey, Ms Ann
Griffiths, Nigel (Edinburgh S)


Cohen, Harry
Griffiths, Win (Bridgend)


Coleman, Iain
Grocott, Bruce






Grogan, John
McIsaac, Shona


Gunnell, John
McKenna, Mrs Rosemary


Hain, Peter
Mackinlay, Andrew


Hall, Mike (Weaver Vale)
McLeish, Henry


Hall, Patrick (Bedford)
McNulty, Tony


Hamilton, Fabian (Leeds NE)
MacShane, Denis


Harman, Rt Hon Ms Harriet
Mactaggart, Fiona


Heal, Mrs Sylvia
McWilliam, John


Healey, John
Mahon, Mrs Alice


Henderson, Ivan (Harwich)
Mallaber, Judy


Hepburn, Stephen
Marek, Dr John


Heppell, John
Marsden, Paul (Shrewsbury)


Hesford, Stephen
Marshall, David (Shettleston)


Hill, Keith
Marshall, Jim (Leicester S)


Hinchliffe, David
Marshall—Andrews, Robert


Home Robertson, John
Martlew, Eric


Hood, Jimmy
Maxton, John


Hoon, Geoffrey
Michael, Alun


Hope, Phil
Michie, Bill (Shef'ld Heeley)


Hopkins, Kelvin
Milburn, Alan


Howarth, Alan (Newport E)
Miller, Andrew


Howarth, George (Knowsley N)
Mitchell, Austin


Howells, Dr Kim
Moffatt, Laura


Hoyle, Lindsay
Moonie, Dr Lewis


Hughes, Kevin (Doncaster N)
Moran, Ms Margaret


Humble, Mrs Joan
Morgan, Ms Julie (Cardiff N)


Hurst, Alan
Morgan, Rhodri (Cardiff W)


Hutton, John
Morley, Elliot


Iddon, Dr Brian
Morris, Ms Estelle (B'ham Yardley)


Illsley, Eric
Mountford, Kali


Jackson, Ms Glenda (Hampstead)
Mudie, George


Jackson, Helen (Hillsborough)
Mullin, Chris


Johnson, Alan (Hull W & Hessle)
Murphy, Denis (Wansbeck)


Johnson, Miss Melanie (Welwyn Hatfield)
Murphy, Jim (Eastwood)



Naysmith, Dr Doug


Jones, Barry (Alyn & Deeside)
Norris, Dan


Jones, Mrs Fiona (Newark)
O'Brien, Bill (Normanton)


Jones, Helen (Warrington N)
O'Brien, Mike (N Warks)


Jones, Ms Jenny (Wolverh'ton SW)
O'Hara, Eddie



Olner, Bill


Jones, Jon Owen (Cardiff C)
O'Neill, Martin


Jones, Dr Lynne (Selly Oak)
Organ, Mrs Diana


Jones, Martyn (Clwyd S)
Osborne, Ms Sandra


Jowell, Ms Tessa
Palmer, Dr Nick


Kaufman, Rt Hon Gerald
Pearson, Ian


Keeble, Ms Sally
Pendry, Tom


Keen, Alan (Feltham & Heston)
Pickthall, Colin


Keen, Ann (Brentford & Isleworth)
Pike, Peter L


Kelly, Ms Ruth
Plaskitt, James


Kemp, Fraser
Pollard, Kerry


Kennedy, Jane (Wavertree)
Pond, Chris


Khabra, Piara S
Pope, Greg


Kidney, David
Powell, Sir Raymond


Kilfoyle, Peter
Prentice, Ms Bridget (Lewisham E)


King, Andy (Rugby & Kenilworth)
Prentice, Gordon (Pendle)


King, Ms Oona (Bethnal Green)
Primarolo, Dawn


Kumar, Dr Ashok
Prosser, Gwyn


Lawrence, Ms Jackie
Purchase, Ken


Laxton, Bob
Quin, Ms Joyce


Lepper, David
Quinn, Lawrie


Leslie, Christopher
Radice, Giles


Levitt, Tom
Rammell, Bill


Lewis, Ivan (Bury S)
Rapson, Syd


Lewis, Terry (Worsley)
Reed, Andrew (Loughborough)


Lloyd, Tony (Manchester C)
Reid, Rt Hon Dr John (Hamilton N)


Lock, David
Robinson, Geoffrey (Cov'try NW)


Love, Andrew
Roche, Mrs Barbara


McAllion, John
Rogers, Allan


McAvoy, Thomas
Rooker, Jeff


McCabe, Steve
Rooney, Terry


McCafferty, Ms Chris
Ross, Ernie (Dundee W)


McCartney, Ian (Makerfield)
Rowlands, Ted


McDonagh, Siobhain
Roy, Frank


Macdonald, Calum
Ruane, Chris


McDonnell, John
Russell, Ms Christine (Chester)


McGuire, Mrs Anne
Ryan, Ms Joan





Salter, Martin
Taylor, David (NW Leics)


Sarwar, Mohammad
Temple—Morris, Peter


Savidge, Malcolm
Thomas, Gareth (Clwyd W)


Sawford, Phil
Thomas, Gareth R (Harrow W)


Sedgemore, Brian
Tipping, Paddy


Shaw, Jonathan
Todd, Mark


Sheerman, Barry
Touhig, Don


Sheldon, Rt Hon Robert
Trickett, Jon


Shipley, Ms Debra
Truswell, Paul


Simpson, Alan (Nottingham S)
Turner, Dennis (Wolverh'ton SE)


Singh Marsha
Turner, Dr Desmond (Kemptown)


Skinner, Dennis
Turner, Dr George (NW Norfolk)


Smith, Rt Hon Andrew (Oxford E)
Twigg, Derek (Halton)


Smith, Angela (Basildon)
Twigg, Stephen (Enfield)


Smith, Jacqui (Redditch)
Vaz, Keith


Smith, John (Glamorgan)
Walley, Ms Joan


Smith, Llew (Blaenau Gwent)
Ward, Ms Claire


Snape Peter
Wareing, Robert N


Soley Clive
White, Brian


Southworth, Ms Helen
Whitehead, Dr Alan


Squire, Ms Rachel
Wicks, Malcolm


Starkey, Dr Phyllis
Williams, Rt Hon Alan (Swansea W)


Steinberg, Gerry



Stevenson, George
Williams, Alan W (E Carmarthen)



Wills, Michael


Stewart, David (Inverness E)
Winnick, David


Stewart, Ian (Eccles)
Winterton, Ms Rosie (Doncaster C)


Stinchcombe, Paul
Wise, Audrey


Stoate, Dr Howard
Wood Mike


Stott, Roger
Woolas, Phil


Strang, Rt Hon Dr Gavin
Wray, James


Straw, Rt Hon Jack
Wright, Anthony D (Gt Yarmouth)


Stringer, Graham
Wright, Dr Tony (Cannock)


Stuart, Ms Gisela
Wyatt, Derek


Sutcliffe, Gerry



Taylor, Rt Hon Mrs Ann (Dewsbury)
Tellers for the Noes:



Mr. David Hanson and


Taylor, Ms Dari (Stockton S)
Mr. David Jamieson.

Question accordingly negatived.

Main Question put forthwith, pursuant to Standing Order No. 62 (Amendment on Second or Third Reading), and agreed to.

Bill accordingly read a Second time, and committed to a Standing Committee, pursuant to Standing Order No. 63 (Committal of Bills).

ROAD TRAFFIC (NHS CHARGES) BILL [MONEY]

Queen's recommendation having been signified—

Motion made, and Question put forthwith, pursuant to Standing Order No. 52(1)(a),
That, for the purposes of any Act resulting from the Road Traffic (NHS Charges) Bill, it is expedient to authorise the payment out of money provided by Parliament of—

(a) fees and allowances to members of any appeal tribunal established by regulations made under the Act;
(b) any other expenditure incurred by the Secretary of State in consequence of the Act; and
(c) any increase attributable to the Act in the sums so payable by virtue of any other Act.—[Mr. Dowd.]

Question agreed to.

SITTINGS OF THE HOUSE

Motion made, and Question put forthwith, pursuant to Standing Order No. 25 (Periodic adjournments),
That this House, at its rising on Thursday 17th December, do adjourn till Monday 11th January 1999.—[Mr. Dowd.]

Question agreed to.

BUSINESS OF THE HOUSE

Ordered,
That, at the sitting on Thursday 17th December, the Speaker shall not adjourn the House until she shall have notified the Royal Assent to Acts agreed upon by both Houses.—[Mr. Dowd.]

Rail Fares

Motion made, and Question proposed, That this House do now adjourn.—[Mr. Dowd.]

Mr. Matthew Taylor: Like me, the Minister will probably be rather pleased that this Adjournment debate is taking place earlier than it might have done. Although I do not intend to speak at length, I am more relaxed about timing than I was.
The train network is an integral part of our daily national life and it will become even more important as we strive to cut the number of unnecessary car journeys to avoid congestion and unnecessary environmental destruction. As things stand, car ownership is predicted to rise by 15 per cent. each decade, and many roads and motorways are already running at full capacity. The rail network is vital in reducing the resulting congestion and air pollution.
Rail could take a bigger proportion of travellers and freight, but it will not do so unless it is made more attractive to passengers and to business. In general, rail fares are too expensive and the fare structure is too complicated. Fares have increased sharply in real terms in the past 20 years, but motoring costs have remained stable or have fallen.
According to Government figures, rail fares rose in real terms between 1974 and 1996 by 74.8 per cent. above inflation. By comparison, the real cost of motoring fell by 3.5 per cent. Travelling by car became far more affordable and train travel became less affordable, so it is no wonder that our roads are so clogged.
According to a Union Bank of Switzerland survey last year, rail fares in this country are now the most expensive on the planet. The cost of train travel in the United Kingdom is almost three times the world average. Since privatisation, the franchising director has regulated key commuter and leisure fares, including saver tickets, unrestricted standard return tickets and all standard weekly season tickets. Indeed, the franchising director has a duty under the Railways Act 1993 to regulate those fares where he considers that regulation is required in the interests of passengers.
The Conservative Government believed that market forces would prevent excessive price increases, leaving operators with the freedom to apply commercial judgment in setting a range of non-regulated fares. Those unprotected tickets include the supersaver—the cheapest national long-distance walk-on rail ticket—cheap day returns, family rail cards and the network card.
As Liberal Democrats predicted, companies have been increasing unprotected fares at rates well above inflation; they are clearly taking advantage of the legislative loopholes in the Railways Act. The increases are targeted largely at casual travellers, such as families, shoppers and people who cannot or do not book in advance, who account for about 40 per cent. of ticket sales. There is a very real fear now that, sooner or later, many of the low-cost regulated tickets will be phased out altogether.
Virgin Trains is the worst offender—perhaps unsurprisingly, since that name comes up regularly in these debates—and recently raised the supersaver on its cross-country network by four times the rate of inflation.


Virgin argues that it is introducing many new discount offers, but those cheap fares must be booked in advance, can be used only on Virgin trains, are limited by train, number of tickets available and time of day, can be purchased only at main stations or by credit card, are often not available for journeys to and from stations on connecting routes and both outward and return trains must be specified in advance. That is confusing, restrictive and clearly by no stretch of the imagination equivalent to the simple supersaver system.
Virgin is not by any means the only railway company poised to take money from many passengers. Midland Mainline is raising its open first-class return fare from Kettering to Sheffield by 26 per cent. On the politically sensitive west coast main line between London and Glasgow—where passenger complaints run at a startling one for every 100 journeys—there will be rises of up to 19 per cent.
In London, the regulator has already punished rail companies for their dismal performance by ordering them to keep increases below 1.9 per cent.—below inflation. Connex, which operates some of Britain's busiest commuter routes through south London, Kent and Sussex, has got around the restriction by raising the price of cheap day returns—which are not protected by the regulator—by an average of 6.5 per cent.
In my own county, we have been hit by two recent examples. In the spring, Great Western Trains restricted the use of saver tickets, banning them from early and late trains. This meant that passengers using the 5.35 pm from Paddington had to pay £120 return, rather than the previously available £58 saver fare. That is the last train to Penzance. Booking in advance would get passengers a fare reduction, but not everybody can do that. The day return discount remains, but a day return from Cornwall to London is hardly realistic, since it would leave only few hours at most in London. If one cannot book in advance, one must pay far more to travel at reasonable times.
Similarly, in 1995, Great Western planned to withdraw group travel arrangements for school parties from certain services. I took that up and got it reversed but, this October, the company did it again. Schools either pay full fare, or must travel when it is convenient for Great Western. In the case with which I was presented, that meant that people were not travelling on an early train to get home at a reasonable time, and were forced to arrive very late at night. Previously, we got the decision reversed almost immediately I took it up. On this occasion, after two months, Great Western has not even bothered to reply to my representations—despite repeated attempts to chase the company up.

Mr. Don Foster: My hon. Friend is right to say that it is not acceptable to have effective fare increases while punctuality is getting worse. However, does he accept that Great Western—which uses his constituency and mine—is not entirely responsible for some of the difficulties? Some of the punctuality problems lie at the door of Railtrack, rather than the operating company. Does he accept that a survey has shown that only 30 per cent. of punctuality problems are the result of Great Western, while 70 per cent. are the result of Railtrack? Does he agree, therefore, that Railtrack should get its act together and do more to help the companies?

Mr. Taylor: I thank my hon. Friend, and there is time for him to elaborate on that point in a speech, if he wishes.

The point is well made. There are problems with Railtrack. As a regular user of Great Western, I have relatively few complaints about the quality of service, and the staff do a superb job. However, on fares, Great Western and others have used the unregulated system as a means of making up the costs of the restrictions on regulated fares. That has done a considerable disservice to passengers in Cornwall, who may, on average, end up paying a little less, but do so for a service that is not at the times they want. There is also the risk that, if they cannot travel at those times, they have to pay considerably more.
All the rail companies argue that, by offering advance booking discounted tickets instead of supersavers, they are not penalising passengers, but that is nonsense. The tickets are generally limited in number, more limited in terms of which services are included and require considerable pre-planning. There is no flexibility if those plans go awry.
The railway is traditionally a "turn-up-and-go" carrier—greatly to the benefit of passengers—and the application of an airline pre-booking style arrangement undermines the flexibility of rail travel. Ultimately, that will reduce the flexibility of passengers to use the service and, therefore, the numbers using it. My fear is that, as the ability of the service to take more passengers increases, profits will be taken from the increases, but flexibility will not be restored. Not all passengers can plan their journeys days or weeks in advance—especially the return leg. They therefore have to choose between a loss of flexibility or a higher—sometimes much higher—fare.
Analysis of ticket types by the Central rail users consultative committee revealed larger fare rises for passengers who purchase their tickets at the time of travelling and smaller fare rises for passengers who buy tickets in advance. Fares that could be purchased immediately before travel went up, on average, by 3.4 per cent., while tickets that had to be purchased in advance went up, on average, by 1.8 per cent.
Average fares paid by passengers are often quoted by the rail companies, and by the Government in official responses, on the ground that average fares paid by passengers have fallen. Those fares have fallen slightly in real terms, it is true, but that masks gains for some at the considerable expense of others. There has been an overall reduction in the flexibility of the service that passengers receive. These have not been free cuts: they have been cuts at the expense of the service that passengers get.
The Central rail users consultative committee—the statutory watchdog protecting and promoting the interests of rail passengers—has revealed that nine out of 25 train operators increased prices in real terms in spite of deteriorating performance, punctuality and reliability. It is not even the case that all companies are offering reduced real-terms prices on average. For instance, Connex South Eastern was able to raise fares by an average of 4.4 per cent. during a period when major delays increased by 30 per cent. and cancellations on the Kent coast services rose by a staggering 100 per cent.
A report issued yesterday by the Central rail users consultative committee set out the passenger charter figures for the year ending September 1998, and showed that the proportion of train delays is now 35 per cent. higher than in the year ending March 1997, which marked the completion of franchising. Complaints to the local


committee network have also continued to rise, and are now more than a third up on the same period last year. In July, August and September of this year, the committee received nearly 5,000 complaints—an increase of 39 per cent. over the same period last year, and a 45 per cent. increase over the April-June total.
In Devon and Cornwall, the South West rail users consultative committee recorded a 200 per cent. increase in complaints last year—the highest in the country, but by no means exceptional. In November, the same committee made one of the more bizarre announcements by the rail industry—almost on a par with "the wrong kind of leaves". It announced that it could not cope with the rising tide of complaints—this is the body set up to receive complaints—and would no longer answer calls in the morning, so that it could deal with the backlog. I suppose refusing to answer the telephone is one way of cutting complaints, but it is not a solution of any help to irate passengers.
Since privatisation, companies have been concentrating their efforts on introducing their own fares, which are available only on their services and from which they keep all the revenue. Revenue from national fares is divided up between the companies. That reduces choice and price competition, and makes arranging travel far more complex.
For inter-city companies, we are moving towards an airline approach—multiple classes, multiple fares and multiple hassle, complication and misery. It is possible with certain companies to pick up cheaper advance fares, but the downside is that the fares structure becomes an impenetrable jungle, which the staff—never mind the passenger—have difficulty in understanding. For example, three different companies operate between Gatwick and central London, offering a total of 36 different standard-class fares.
Rail travellers are now being hit by a further blow: the withdrawal, not for the first time, of cheap travel over Christmas. That is a Scrooge-like measure at this time of year. Supersaver tickets have been cancelled from 18 December to 1 January. With increasing complaints, delays and cancellations, and the certainty of packed trains, the least the rail companies could do this year is to stop being Scrooge and offer a little Christmas spirit by maintaining saver tickets; that is, if anybody can find the right train in the first place: the Christmas timetable should have been available in early October but, like many services, it is running late. Some Christmas journey timetables have still not been published two weeks before Christmas.
Liberal Democrats opposed the Conservative Government's privatisation of the railways because we foresaw problems such as higher fare increases on non-regulated tickets, confused booking arrangements and deteriorating service. We and the Labour party did not believe that privatisation would deliver either a high quality of service or the necessary investment. Since privatisation, quality has indeed continued to decline. Private partnerships to increase investment in the system would have made sense; the botched system that we got did not. No wonder not a single Conservative Member is present for this debate.
I know that the Government accept that they need to tackle rail companies that continually abuse franchise loopholes, but their commitment to rail travel has so far failed to get legislative backing. I welcome the news that the Deputy Prime Minister announced this week: that, as a result of agreement on the handling of House of Lords reform, the Government hope as a priority to introduce legislation to establish a strategic rail authority. But that is not definite, to say the least, as the Conservative leader clearly has other ideas about that agreement, as we all know.
Frustrated rail travellers this Christmas may well wonder why the Deputy Prime Minister failed to secure the Bill in the Queen's Speech in the first place. They have heard the rail companies blaming the wrong kind of leaves for delays; perhaps this is an example of the wrong kind of Lords.
It is time for action. Welcome as the Government's words have been, non-regulated fares are going up at high speed, despite the fact that more and more trains are late or cancelled. The only answer is high-speed legislation from the Government to sort out the situation in the new year, not a further delay into the new millennium.

Mr. Paul Tyler: I am grateful both to the Minister and to my hon. Friend the Member for Truro and St. Austell (Mr. Taylor) for allowing me to make a brief contribution.
My hon. Friend, who normally speaks loudly and clearly on behalf of Cornwall, has taken a national perspective this evening, so I shall indulge in being rather more parochial than usual. I have one of the most rural constituencies in the United Kingdom, with only 100 yd of mainline railway. We have a branch line of which we are all extremely proud, and we hope that we can keep it, but we do not have a great railway service. Far be it from me to suggest that we should reopen all the lines that used to traverse the constituency, because that would cost a great deal.
Any effort to assist those who live in sparsely settled rural areas to get access to public transport will be a long and difficult process. We warmly welcome the Government's commitment to assisting people in rural areas, but access to the main railway network is extremely difficult for many of my constituents. That does not mean that we should not attempt to improve access. Many of my constituents have to travel many miles before they can reach a railhead, but it is none the less important for them to have access to the national and—through the channel tunnel—international rail network.
Cornwall has a high percentage of people who, through age or disability, have no access to cars. Welcome as the Government's commitment to rural public transport is, it would be even more impressive if we had more commitment to those who want to use that transport. There is no contradiction: it is perfectly possible to devise subsidies to support services that will not provide what people in fact need.
That is why we were especially glad that the Deputy Prime Minister committed himself to a national concessionary fare for public transport for all retired people. I hope that the Minister will spell out in a little more detail how that will work and what the time scale for implementation will be.
The comparatively urban communities that can provide concessionary fares tend to be the ones that least need them, for the simple reason that the distances to be travelled are much shorter, while more rural areas tend to have few or no concessionary fare schemes for the retired and the disabled. It is clearly preferable to subsidise passengers to fill trains—and buses—rather than subsidising operators for the losses that they make through vehicles being empty. I hope that that principle will underline the introduction of the scheme. More detail, please, and as early as possible. Many organisations and individuals feel that the scheme is the right way forward, but it must be introduced urgently.
As my party's Chief Whip, I underline our commitment to say godspeed to any legislation that will improve the Government's strategic control over the rail network: both Railtrack and the operating companies. That is urgent. If, as a result of the shenanigans at the other end of the Corridor last week, there is real progress in other legislation, I hope that the Government will find it possible urgently to introduce legislation to improve public transport.
I know that there are other candidates for any vacant slot in the legislative programme, and I would not want to express any great preference between freedom of information, the food standards agency and the strategic rail authority, but I hope that the Minister will take it from us that we wish her the very best of luck in trying to get the rail legislation into the programme.

Mr. Norman Baker: I entirely agree with the comments of my hon. Friends the Members for Truro and St. Austell (Mr. Taylor) and for North Cornwall (Mr. Tyler). The fact that there are so many Liberal Democrats present tonight underlines my party's commitment to rail issues. Excluding yourself, Mr. Deputy Speaker, 75 per cent. of those present were Liberal Democrats, until the most recent arrivals—the figure may now be 60 per cent., and declining as I speak.

Mr. Matthew Taylor: Still no Tories.

Mr. Baker: That is true.
We must consider rail fares as a crucial part of the rail industry as a whole. Rail fares are important for social reasons. Many people who depend on public transport have no access to private motor vehicles, and it is doubly unfair for those—often in rural constituencies such as mine and those of many of my hon. Friends—who cannot afford cars to have to pay over the odds for train tickets.
As my hon. Friend the Member for Truro and St. Austell said, rail fares have increased dramatically compared with the increase in the cost of motoring over the past 20 years. That cannot make any sense socially or environmentally, as I am sure the Minister will agree. We and the Government want more people on trains and fewer on the roads. It would be helpful if the Government would commit themselves to a target under the road traffic reduction legislation, so that we can know that in a set period, perhaps four or five years, there will be a reduction target for the vehicles on our roads or the mileage that they clock up.
The Minister said earlier this Session that if no action was taken there would be a 9 per cent. increase in vehicles on our roads, or their mileage. That cannot be allowed

to happen. We must get more people on trains. A key way to do that is to reduce fares—to eliminate some of the problems that have occurred over the past 20 years, when rail fares have rocketed.
I, too, will be parochial in this short debate and speak about my constituency. We have had a plan in my constituency for the massive upgrading of the trunk road—the A27—between Lewes and Polegate. I declare an interest, living next to the trunk road and next to the railway line. We live in an old railway cottage and therefore benefit or otherwise from both of those pieces of infrastructure.
The previous Government had a plan to spend £80 million on adding four lanes to the existing two lanes of the A27, without even looking at the potential of the parallel rail line. This Government have said that they are prepared to consider the integration of road and rail, and they must do that. If rail fares can be cut, even if that involves public money, that will help to solve traffic problems far more than spending on infrastructure works.
We must get away from the days when we were told that money spent on roads is investment and money spent on rail is subsidy. That is nonsense. Money spent on rail is investment as well, no matter whether it is spent on reducing fares or on infrastructure. Whether it meets a social and environmental end, helps to move people around or helps the economy, those are the criteria that the Government should use, rather than some artificial Treasury figure created in 1942, in setting out what should be invested in our infrastructure. The Government should not shy away from considering direct investment to reduce rail fares, if that is the most satisfactory way of achieving their integrated transport objectives.
My hon. Friend the Member for Truro and St. Austell rightly mentioned Connex and what the company has done to certain fares in south London. I have been negotiating with the company in my constituency, and I am happy to say that partly as a consequence of that—no doubt other factors are involved—certain off-peak fares from Lewes, Newhaven, Seaford and Polegate to London have been cut by 25 per cent. That is what we should encourage other train operating companies to do.
On the Carlisle-Settle rail line a few years ago, British Rail used to shut stations, reduce services, increase fares and then say that the line was not economic. After much pressure from the public, BR reversed its policy and started opening stations, marketing the line and attracting passengers, and the line is now a success. Rail companies can improve financial accountability and profitability by cutting fares. That is the message that I have given my local rail company, and I hope the same message will come out of the House tonight.
All the way through my constituency, we have rail lines parallel to roads. It would make a wonderful example for a case study, if the Government were minded to do that. We would be happy to co-operate if such a study were undertaken. The congestion problems on the trunk roads in my constituency could largely be solved if rail travel was made more attractive by reducing fares, introducing new rolling stock and making stations safer. If that is done, there will not be a problem on the A27 or the A26. We must start considering lateral solutions.
I shall mention one or two other matters, to which I hope the Minister will respond. National rail inquiries is not coming up to standard in terms of the number of calls


answered within the due time—less than 90 per cent., according to the most recent figures. More to the point, it gives conflicting and inaccurate information regarding both the appropriate route for passengers to take and the cost of fares available on particular routes.
What quality measurement is taking place at national rail inquiries? It is easy to measure the speed of response to calls, but who is measuring the quality of the answers given by national rail inquiries? The answers given leave something to be desired. I suggest that quality is being sacrificed in an effort to reach the target of 90 per cent., as failure to meet it could result in a fine. That is not to the benefit of rail passengers.
The powers of the strategic rail authority need to be clarified. We are told that it will be introduced in shadow form or in full during this Session. What powers will it have? What powers will it take away from Railtrack? In my view, it should take away Railtrack's safety responsibilities. What powers will it have over fare levels? How will it interact with the rail regulator, Opraf?
My hon. Friend the Member for North Cornwall mentioned the problems of elderly people travelling. A parliamentary answer that I received from the Minister this afternoon showed that the number of people who have bought a senior citizens railcard has dropped dramatically since 1990, although it has gone up over the past year. The population is getting older, so there should be more, not fewer, people buying such tickets. A disincentive has been applied to that ticket. Presumably, if older people are not buying the railcard, they are either using their cars or not travelling, neither of which is satisfactory if we want to encourage freedom of movement for all sections of society, including the elderly.
I accept that the problems are not the Government's fault because of what they inherited. I hope that they will be tough on the train operating companies where necessary, and perhaps also tough on the causes of the train operating companies, although they are not present tonight. I hope that the Government will introduce the strategic rail authority as soon as possible, give it firm powers and ensure that fares on our trains are cut.

Mr. Phil Willis: I am delighted to make a brief contribution to the debate. My constituency is not as rural as that of my hon. Friends. Harrogate and Knaresborough is an urban constituency, but we rely heavily on rail transport for the economic regeneration of the town and to get people in and out of the former West Riding conurbations, where they travel to work each day.
Harrogate boasts one of the largest conference and exhibition businesses in the United Kingdom. The Liberal Democrats will be holding their conference there next year. The conference and exhibition facilities attract visitors from all over the world. They arrive at Leeds-Bradford airport, which is an excellent regional airport, and travel to the constituency by road. It can take them as long to get from the airport into the conference centre as it took them to fly up from London, because of traffic congestion on the roads.
If people come up by train from London to York, they will have one of the best rail services in Europe. Great North Eastern Railway undoubtedly runs a Rolls-Royce

service between London and Scotland on the east coast main line. I have no difficulty in praising GNER for running such a first-class service. However, people get off the train at York and have to wait for what can only be described as a horse and cart. The service provided by Northern Spirit between York and Harrogate and on to Leeds is unacceptable as we move towards the next millennium. It is a service more fitting for the 1950s than for the 21st century.
Because of the poor quality of the service and of the rolling stock, it is difficult to sell the service to the public who would wish to use it. The part of the line from Harrogate to Leeds is well used, especially at peak commuter times. It is impossible to get on the train particularly at the Leeds border, the point at which it hits the former West Riding passenger transport executive area. From that point on, there are subsidised fares, and, it is possible to travel at significantly reduced rates at peak and off-peak times. As soon as the train crosses the border from Leeds and North Yorkshire into my constituency, there are no such benefits or subsidies, and the people who rely on the line must pay the full fares despite having all the inconveniences of the line.
The Minister's right hon. Friend the Deputy Prime Minister claimed that passenger transport executives would be extended, and that all authorities in the United Kingdom would receive the same benefits. Then, groups of people in large conurbations would not be treated differently from others in more rural and isolated areas, who, it could be argued, are more dependent on public transport. The people of my constituency certainly rely on public transport, and I hope that the Minister will tell us her plans to extend the benefits of passenger transport executives across the UK, and particularly into Harrogate and Knaresborough.
Many people in my constituency are elderly. People traditionally retire to Harrogate and Knaresborough as the constituency is beautiful and has many advantages. However, if they want to use the rail transport network to get to Leeds or York at either end of the line, especially if they have an ambulant disablement, they face real difficulties. The two ends of the line boast two of the largest stations in the UK, but they have not one escalator between them. Huge improvements are happening at York station, but when I asked when escalators would be installed, I was told that there would be none. I asked about the multi-million pound investment in Leeds station, and was again told that there would be no escalators.
It is extremely difficult for people who have mobility problems to use our stations. If we want people to use the railways, we have to provide facilities not only on trains, but in stations. Only then will people of all classes be attracted to using the system.

The Parliamentary Under-Secretary of State for the Environment, Transport and the Regions (Ms Glenda Jackson): I congratulate the hon. Member for Truro and St. Austell (Mr. Taylor) not only on securing the debate, but on managing—though not single-handedly—to introduce it earlier than expected into the House's programme this evening. He has afforded an opportunity to several of his hon. Friends to make speeches.
The hon. Members for North Cornwall (Mr. Tyler), for Lewes (Mr. Baker) and for Bath (Mr. Foster)—I regret that the last-named hon. Member is not in his place—


have each, in their individual and inimitable ways, raised the issue of rural transport, or, rather, the marked lack of it. Although the essential thrust of the debate raised by the hon. Member for Truro and St. Austell had to do with the failure of the railways to provide a first-rate service to the millions of people who are willing to travel on them, other issues have been raised.
The hon. Member for North Cornwall spoke of access to the railways from his rural constituency. He will be aware of the sizeable rural bus grant—£50 million every year for the next three years—which is being specifically targeted at tackling the type of issues that he and his hon. Friends have raised. Additional sums were available for a rural bus competition that sought innovative schemes to deal with the most sparsely populated and most dispersed rural communities, and we shall soon announce the results.
The hon. Members for North Cornwall, for Lewes and for Harrogate and Knaresborough (Mr. Willis) spoke of how pensioners feel themselves to be impacted against. There again, the Government have taken steps to redress that position. Although few local authorities provide concessionary fares for their pensioners, as the House will know the Government have said that there will be a national scheme and it is proposed that all pensioners will be able to have them for a down payment of £5.
In the first instance, we are obviously concentrating on our bus network. We want bus services to increase and to integrate with rail services. The hon. Member for Lewes mentioned the availability of senior citizens' railcards and I have noticed the downturn in applications for the railcard in the past few years. In common with the hon. Gentleman, I am delighted that the figures are now rising, but I am not convinced that the failure to apply is necessarily due to the cost; it is due to the fact that our railways have not provided the type of service that we need.
The hon. Member for Harrogate and Knaresborough mentioned the inaccessibility of many stations. Through the Disability Discrimination Act 1995, the Government are committed to ensure that all public transport is accessible to all our citizens. Indeed, from 1 January all new rolling stock must be accessible to everyone, but I would not attempt to convince hon. Members—nor would I be believed if I did—that all rolling stock will be accessible on that date; nor would I be believed if I attempted to convince them that all our stations will be accessible.
All hon. Members who spoke mentioned the need for a strategic rail authority. The lack of investment that marked the previous Administration for decades underlies all the specific and general problems that were raised tonight. The fact that investment in our railway network—

Mr. Bob Russell: Will the Minister comment on the total absence of the official Opposition? Is that a boycott, a snub, or evidence of a could-not-care-less attitude on the part of the Administration who left us in this situation?

Ms Jackson: I would like to think that that absence is due to a sense of shame, but that is highly unlikely as the Opposition markedly failed to express any of that attribute in anything that they said before or after their crushing defeat.
Essentially, the issue is the failure to invest adequately post-privatisation. As the hon. Member for Truro and St. Austell said, the Liberal Democrat and Labour parties campaigned ferociously against what we still believe to have been a benighted policy. Post-privatisation there has been no strategic authority capable of directing, in the national interest, where investment should go. That would be one of the central responsibilities of the strategic rail authority and I was delighted that hon. Members welcomed the Government's proposal to create one.
I took on board the suggestion that the necessary legislation might be introduced sooner rather than later because of what I can only describe as some bizarre goings-on at the other end of the Corridor and the even more bizarre reactions to them by the Leader of the Opposition. As hon. Members will know, however, we have given a commitment that a shadow strategic rail authority will be in place by next April—we hope.

Mr. Tyler: I am glad to hear that, but will the Minister deal with the problem of co-ordination between the rail and bus networks? In the previous Parliament I was our party spokesman on transport during part of privatisation process and, as she rightly said, Labour and Liberal Democrat Members stood shoulder to shoulder to try to prevent the desecration of our rail system. One problem that resulted from the deregulation of the bus network in 1983 was the overall lack of co-ordination and integration between public transport services. In a constituency such as mine, if bus services do not link with train services, all the work that the strategic rail authority might do could be undermined.

Ms Jackson: I entirely agree and the train operating companies are beginning not only to talk to each other but to take on board the fact that—

Ms Candy Atherton: I am seeking a meeting with Great Western to put the views of my constituents on rail fares and the lack of a train service to meet their needs. It has been brought to my attention that travel between Falmouth and Camborne and Paddington was faster in the 19th century than it is today. I find that staggering, as I am sure does the Minister. Does she support me in seeking that meeting to make the case for my constituents?

Ms Jackson: I strongly support my hon. Friend in her desire for a meeting with her train operating company. She is right about journey times. Across central London, they are about the same as they were in the 18th century. That is another thing that the Government are committed to addressing and redressing.
The hon. Member for North Cornwall mentioned the integration of the various transport modes. I believe that both the train operating companies and the bus providers realise—certainly we have urged them to—that the competition is not with one another but with the private car. That is not exclusively because bus and train companies are often one and the same, although bus companies have invested in train operating companies. As I have had occasion to say before, if they cannot provide high-quality services, and the choice is between sitting in


an ever-growing traffic jam and standing on a wet, windy pavement or platform waiting for a vehicle that may not arrive, the car will win hands down every time.

Mr. Matthew Taylor: As several bus operators have taken over rail companies, does the Minister agree that it is unacceptable for companies to think that branch line services in particular can be replaced by bus services? There is a tendency in that direction. They clearly believe that there may be profits to be made from doing it.

Ms Jackson: If companies are approaching the matter on the basis of not expanding and increasing services, it is clearly something that one would not welcome. However, I will not say categorically that, in every instance, the best quality of service that can be provided, particularly in sparsely populated rural areas, must be the maintenance of a branch line, when an infinitely better, faster, more modern, more accessible service could be provided by, say, a coach that linked up with the main line.
However, all such proposals must be considered individually; there cannot be a blanket yes or no. That is one reason why the Government have found extra money for two new funds—the investment fund and the passenger fund. They will act as the seedcorn to bring together a partnership comprising several interests to advance a business case that could, for example, revitalise a branch line if custom warranted it.
The hon. Member for Harrogate and Knaresborough mentioned passenger transport executives and authorities. The recurring theme that informs Government thinking is the integration of our transport modes. We are looking to local authorities to create integrated transport plans for their areas. Again, we have made a major breakthrough, because they will be expected to submit plans that will take three to five years to complete, and involve budgets that will run for three years. We have got away from the annual begging bowl round for local authorities in presenting their transport plans. The integrated transport plans will have to fit in with the much wider regional transport plans.
I was impressed when I took part in four of the eight meetings between Ministers and the regional authorities by just how much co-operation and partnership is already in place throughout the country. I was impressed by the willingness—indeed, eagerness—of local and regional authorities to work together and to advance policies to produce the transport plans the country so desperately needs. We are talking about integrated transport, which requires that everyone involved should work together in a genuine spirit of partnership.

Mr. Willis: I am grateful for the response that the Minister has just made. May I clarify the issue of subsidies? The huge subsidies that are going into some of the existing passenger transport executives do not equate with the subsidy that goes into a county such as North Yorkshire. Is the Minister saying that resources will be equalised on a regional basis, or shall we still have inequities in grant aid?

Ms Jackson: If the hon. Gentleman is thinking of some of the passenger transport authorities and executives of

which I am aware—I hope that he will not take it as an insult, but the one that most immediately comes to mind is Greater Manchester—my reply is that we have seen massive investment in rail infrastructure by those local authorities. The hon. Gentleman would call it special grant, but there has to be a balancing of the amount that such authorities have already invested to ensure that the investment gives a return.
We have managed, following the comprehensive spending review, to make available an additional £700 million for local authorities' transport plans. We have also introduced hypothecation. Local authorities will, via congestion charging and a private non-residential parking levy, be able to raise an income stream, which they will be able to use only for improving transport in their area. I repeat that local authorities will be expected to submit plans. They can plan for three to five years with the assurance that there will be budgets. We have got away from the annual begging bowl round.
I trust that the hon. Member for Truro and St. Austell will forgive me for concentrating in the first part of my speech on the points made by his hon. Friends, many of which were inherent in his speech. I assure hon. Members on both sides of the House, and, indeed, the entire country, that issues surrounding transport in rural areas are central to the Government's thinking. We are well aware of the difficulties in many rural areas. We have taken major steps to address them. This is not empty rhetoric. We have put the wherewithal—money—behind it, to begin to address and redress the issues.
I am sure that the House and the country will agree that the last thing that rail passengers want for Christmas—the hon. Member for Truro and St. Austell dubbed some of the train operating companies Scrooges—is news of even more fare rises. But with key fares now regulated by the franchising director, widespread annual above-inflation January increases are now a thing of the past.
However, despite that good news, I remain concerned—the speeches by other hon. Members this evening have confirmed that I am not alone in my concern—that some unregulated off-peak fares continue to increase above the rate of inflation. The growth market in discount fares has not stopped some operators putting up the prices in real terms of unregulated cheap day returns, supersavers and similar discounted fares. The hon. Member for Truro and St. Austell gave some detailed information on that issue.
That has happened not only in the south-west but in many parts of the country, which will be of no comfort to the hon. Gentleman or any of his constituents. Basic economics surely dictates that higher fares will not encourage more people to travel by train. Train operators have to consider whether increasing off-peak fares is the best way to attract new rail passengers and fill spare capacity.
The absence of control over unregulated fares is a consequence of legally binding franchise agreements inherited from the previous Government. I regret that there is little practical scope for altering the current arrangements in the short term. However, we have made it clear that, when opportunities arise for negotiating franchises, the new strategic rail authority will ensure that arrangements are made to ensure that train operators structure and market their fares to offer value for money for their passengers, and to reflect the fact that our railway


is a national network, which needs to be marketed accordingly and in a way that encourages people to switch from car to train.

Mr. David Drew: I should like to raise two issues on which my hon. Friend the Minister might care to comment. The first is the definition of "peak" times, which is a fairly elastic phrase. Secondly, the problem is not only what people pay, but the service they receive. The trains are now a worse-kept secret, and many people use the train only to be put off by the low-quality service they receive—for example, the train is overcrowded, or there is no buffet car. The two problems must be tackled together.

Ms Jackson: I entirely agree with my hon. Friend. In his own way, he underlines a point made by several hon. Members, which is that there has been a lamentable lack of investment in our railways, not only in infrastructure, but in rolling stock. We cannot drag back the wasted years, but we can, via the strategic rail authority, begin to ensure that investment is not only adequate in terms of amounts, but strategically placed, so that the improvements that everyone wants take place.

Mr. Andrew George: Following the points raised by the hon. Member for Stroud (Mr. Drew), would the Minister care to comment on one of the many anomalies resulting from the way in which the rail service was privatised—the role of rolling stock companies? In my part of the world, many trains on branch lines run with only one carriage when there should be three or four. The Minister may correct me, but my understanding of what the service operators tell me is that they have no recourse against the three rolling stock companies that supply those shoddy services.

Ms Jackson: The hon. Gentleman introduces the subject of rolling stock companies. If I get started on that subject, any benefits the House has gained from the Adjournment starting sooner than expected would totally disappear. It was surely one of the most crass aspects of rail privatisation that the rolling stock companies were sold off at a fraction of their real worth, and entirely outside the regulatory system. Orders are now being laid, and new rolling stock will come on to our railways, but that is not before time.
The pieces of good news that I recounted at the start of my speech will be of little comfort to the hon. Member for Truro and St. Austell, as many of his constituents have seen their fares increase by more than inflation. Last summer's decision by Wales and West Passenger Trains to ban cheap day returns to several popular holiday resorts in Cornwall might have made sense to the train operating company and helped it to manage overcrowding, but it is a bitter pill for passengers, many of whom are totally reliant on those rail services for their own essential travel. In addition, I very much doubt that high local fares benefit the Cornish local economy, dependent as it is on tourism and holiday travel.
I know that Great Western Trains has also made changes to its fares for journeys between London and Cornwall. I am aware of concern about the fact that saver tickets are no longer available for use on the popular 5.30 pm departure from Paddington—a point raised by the hon. Member for Truro and St. Austell. However,

I understand that Great Western Trains has made arrangements to accommodate day travellers from Cornwall to London by other means, including a flexible all-day services day return ticket and the super advance fare.
I would be surprised and disappointed if train operators did not consider different ways of meeting the needs of their passengers, and providing them with good value for money for the journeys they wish to make. As well as meeting the fares regulation requirements, train operators must show the franchising director that they are improving their customers' satisfaction with the service and value on offer.

Mr. Matthew Taylor: As the rail regulator and Great Western will undoubtedly refer to this debate, it is important to make it clear that a day return from Cornwall is no substitute for a saver fare, because few people will make the round trip to London in a single day. The time is very limited. The only real option is the advance fare, and not everyone is able to make use of it.

Ms Jackson: It is entirely probable that the rail regulator and Great Western Trains will attempt to obtain a copy of the Official Report to read this debate. If they do not, I assure the hon. Gentleman that I shall certainly bring it to their attention.
Recent research has shown that, on average and in real terms, fares overall have been falling since privatisation. From January 1999, key fares such as saver tickets, unrestricted standard returns where there are no savers, and all standard weekly season tickets, will be capped at 1 per cent. below the rate of inflation. They will remain capped for each of the next four years.
In the London, Edinburgh and Cardiff areas, where there is significant commuting and the railways exercise considerable monopoly power, all standard season tickets and a range of standard singles and unrestricted standard returns are also capped. For non-lnterCity London commuter fares, the fares cap can be adjusted further to reflect the quality of service provided by operators—a point made by the hon. Member for Truro and St. Austell.
With the exception of Silverlink trains, the average permitted increase in London commuter fares has been capped below the rate of inflation, to reflect falling performance levels over the last year. That means a reduction in real terms for passengers. However, as many passengers have told me, they want reliability more than anything else: they want the train to be there when they arrive at the station, and they want to be sure that it will arrive at its destination at the advertised time.
Passengers expecting the usual January fares increase will have been surprised by Connex Rail's announcement last week that it would be reducing the cost of many commuter rail fares in the south-east. Connex Rail's decision should help to make rail travel more attractive and encourage people to leave their cars at home—and every hon. Member who has spoken this evening has stressed the desirability of that outcome. I strongly welcome that move, and I hope that it will mark the beginning of a trend to attract more passengers with value-for-money fares across the rail network.
I also welcome moves by train operators to promote discount fares such as Apex—I know that the hon. Member for Truro and St. Austell does not share my


view of that method of selling tickets—and other advance-booked products to attract people to their services, particularly in off-peak hours, when space capacity currently exists. As a result, passengers are using the cheapest tickets more than ever before.
The take-up of journeys made by purchasing Apex and similar advance-booked tickets has increased by 40 per cent. in two years. Indeed, the increase in the average fare paid between April 1996 and April 1998 was only 3 per cent.—below the rate of inflation. Popular discount railcard schemes—the senior railcard, the young persons railcard and the disabled railcard—which allow reduced rail travel for holders have also been protected by the franchising director.
One of the obvious failures of rail privatisation has been the perceived lack of a clear, understandable, national fares structure. Although I welcome many of the new and innovative fares introduced by train operators, they have led to a multiplicity of different and frequently changing fares for similar services, with, in some cases, complex and varied conditions—for example, in relation to advance booking.

Mr. Colin Breed: I want to try to ensure that every hon. Member from Cornwall speaks tonight, so I shall relate to the Minister an experience that I had a few weeks ago when I was trying to book a ticket.
I waited in the queue for about 20 minutes with nothing else to do, so I decided to time the people standing at the full inquiry desks, where three clerks were trying to work out fares. That is difficult for the public to do. Even the clerks, poring over computer screens and huge books, were taking five to six minutes to deal with each inquiry. Surely there is a better method, whether it uses a paper or computer system. Inquiries about the best ticket for a particular journey must take less time. To stand in a queue for nearly half an hour, as I did, while clerks spend five to six minutes on each inquiry will clearly put people off travelling at all.

Ms Jackson: It may be of some comfort to the hon. Gentleman to know that the Association of Train Operating Companies is engaged in producing a high-tech system that will mean that the wait to which he was subject, and which many would-be rail travellers suffer, will be a thing of the past. I am in no position to say when that system will come on line, but it will do so. Of course, as I have said, that does not attack the problem of the multiplicity of fares and people's sheer inability to understand how they are arrived at, which we want to be addressed.

Mr. Baker: Before the Minister concludes—she seems to be coming to the end of her remarks—will she respond to my earlier point about the quality of response from national rail inquiries in dealing with the multiplicity of fares, which is diminishing so that they can meet their targets of answering a call on time?

Ms Jackson: The hon. Gentleman should have more faith—I intended to deal with that issue before I

wound up. As he has pushed me, I say to him that we are disappointed that the rail regulator has had occasion, yet again, to impose stinging fines on the Association of Train Operating Companies over the failure of the national rail inquiries system. I have regular meetings with the association, and I assure all hon. Members who have spoken that I will raise with the association the issues that have been mentioned tonight.
I am concerned about the complexity that passengers often face when booking an apparently simple journey. The hon. Member for South-East Cornwall (Mr. Breed) related a direct personal experience of that. I am particularly concerned that there may be instances of passengers paying more than they should or receiving inaccurate advice about the service and routes they may use. As I said, we can do little to change the current fares arrangements in the short term, and I do not want to deprive passengers of many popular bargain fares that are now widely available. However, it is surely not too much to ask train operators to make sure that they correctly advise passengers on every occasion.
When I and my right hon. Friends the Deputy Prime Minister and the Minister of Transport met train operators and Railtrack last month, we made it clear that we expect progressive year-on-year improvements from the industry starting over the next 12 months. Passengers want an efficient, reliable and reasonably priced rail service. I assure the House that we shall do everything in our power to ensure that train operators redouble their efforts to deliver a good service at a reasonable price.
I shall discuss with the train operating companies the issues that have been raised, including that of school parties, which the hon. Member for Truro and St. Austell mentioned. That could be addressed. There are considerations of capacity but, as the hon. Member for Bath, who I regret is not in his place, has said. Railtrack has failed adequately to invest in certain parts of the network. We have discussed the failure of the rolling stock companies to provide new stock.
Although we argued against rail privatisation, as did Liberal Democrats, we have to acknowledge that we are where we are. We have to move forward. Vast amounts of public money are still going into our railways. I was interested to hear that the hon. Member for Lewes has opted for our approach to this. Money put into roads was deemed by the previous Administration to be investment, but money put into railways was subsidy. We totally reject that argument.
For a variety of reasons, not least the environment and economic sustainability, we are committed to ensuring that our railways carry more passengers and more freight. We have made it abundantly clear to the train operating companies and to the entire railway industry that there is potential for a renaissance in our railways, but it will be achieved only by everybody working together. If we need to push and shove a little, the Government are determined to do that.

Question put and agreed to.

Adjourned accordingly at five minutes past Nine o'clock.